26705 Closed treatment of metacarpophalangeal dislocation, single, with manipulation; requiring anesthesia

Name of the Procedure:

Closed treatment of metacarpophalangeal dislocation, single, with manipulation; requiring anesthesia.

Summary

This procedure involves realigning a dislocated metacarpophalangeal (MCP) joint in the hand without making any surgical cuts. It requires manual manipulation of the joint and is performed under anesthesia to ensure the patient does not feel pain during the realignment.

Purpose

This procedure addresses the dislocation of an MCP joint, typically caused by an injury or trauma. The goal is to restore the proper alignment of the joint to allow normal function and alleviate pain.

Indications

• Visible deformity of the finger joint.
• Inability to move the finger.
• Severe pain and swelling at the joint.
• Recent trauma or injury to the hand.

Preparation

• The patient may need to fast for several hours before the procedure if general anesthesia is used.
• Adjustments to medications, especially blood thinners, may be necessary.
• Pre-procedure imaging studies, such as X-rays, are required to assess the extent of the dislocation.

Procedure Description

1. The patient is positioned comfortably, and anesthesia is administered.
2. The affected hand and joint are sterilized.
3. The healthcare provider manually manipulates the dislocated joint back into its proper position.
4. After realignment, the joint is immobilized using a splint or cast to maintain the correct position.
5. Post-procedure imaging may be performed to confirm successful realignment.

Duration

The procedure typically takes about 15 to 30 minutes, excluding preparation and recovery time.

Setting

• Hospital emergency room
• Outpatient clinic
• Surgical center

Personnel

• Orthopedic surgeon or trained physician
• Nurses
• Anesthesiologist or nurse anesthetist

Risks and Complications

• Pain or discomfort during and after the procedure
• Infection at the manipulation site
• Possibility of incomplete realignment requiring further intervention
• Swelling and bruising
• Stiffness or reduced range of motion in the affected joint

Benefits

• Immediate pain relief.
• Restoration of normal joint alignment and function.
• Minimally invasive compared to surgical options.
• Faster recovery time.

Recovery

• Patients may experience some discomfort, which can be managed with pain medication.
• The affected hand should be kept elevated and immobilized as directed.
• Follow-up appointments are necessary to monitor healing and joint stability.
• Physical therapy may be recommended to restore normal function.

Alternatives

• Open surgical reduction
  • Pros: Direct visualization of the joint, often more effective for complex dislocations.
  • Cons: Longer recovery time, higher risk of complications.
• Non-surgical management with prolonged immobilization
  • Pros: Avoids surgical risks.
  • Cons: Potential for prolonged joint dysfunction and residual deformity.

Patient Experience

• The patient will be under anesthesia and should not feel pain during the procedure.
• Post-procedure, patients may feel some soreness and swelling around the joint.
• Pain management strategies and comfort measures will be provided to ensure optimal recovery.