26665 Open treatment of carpometacarpal fracture dislocation, thumb (Bennett fracture), includes internal fixation, when performed

Name of the Procedure:

Open treatment of carpometacarpal fracture dislocation, thumb (Bennett fracture), includes internal fixation, when performed.

Summary

This surgical procedure addresses a Bennett fracture, which is a break and dislocation at the base of the thumb where it meets the wrist. The surgery involves repositioning the broken bone and fixing it in place with hardware to ensure proper healing.

Purpose

The procedure aims to:

• Correct the fracture and dislocation of the thumb joint.
• Restore proper function and alignment.
• Alleviate pain and improve mobility.
• Prevent long-term complications like arthritis.

Indications

• Severe pain and swelling at the base of the thumb.
• Limited thumb movement and grip strength.
• X-ray confirmation of a Bennett fracture.
• Instability or misalignment of the thumb joint.

Preparation

• Typically, patients are advised to fast for 8 hours before the procedure.
• Certain medications may need to be adjusted.
• Pre-procedure diagnostic tests include X-rays or CT scans of the thumb.

Procedure Description

1. The patient is administered general or regional anesthesia.
2. An incision is made over the base of the thumb.
3. The fractured bone is realigned manually.
4. Internal fixation (using screws, plates, or pins) is used to stabilize the bone.
5. The incision is closed with sutures, and a bandage or cast is applied.

Duration

The procedure typically takes about 1-2 hours.

Setting

This surgery is usually performed in a hospital or an outpatient surgical center.

Personnel

• Orthopedic surgeon
• Anesthesiologist
• Surgical nurses
• Radiology technician (if real-time imaging is needed)

Risks and Complications

• Common risks: Infection, bleeding, and swelling.
• Rare risks: Nerve damage, blood clots, and hardware issues.
• Possible complications: Nonunion or malunion of the bone, chronic pain, or arthritis.

Benefits

• Proper bone healing and alignment.
• Improved thumb function and strength.
• Pain relief.
• Reduced risk of long-term joint issues.

Recovery

• Patients may need to wear a splint or cast for several weeks.
• Pain management involves prescribed painkillers and ice packs.
• Physical therapy might be needed to regain full function.
• Total recovery time can range from 6 weeks to 3 months.
• Follow-up appointments to monitor healing and remove hardware if necessary.

Alternatives

• Closed reduction and casting, which may not provide the same stability.
• Percutaneous pinning for less severe fractures.
• Conservative treatment with immobilization if surgery is not feasible.

Patient Experience

Patients will be asleep or numbed during the procedure. Post-surgery, they may feel pain managed by medication. They should expect some discomfort and swelling but will be provided detailed care instructions to aid recovery.