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Closed treatment of interphalangeal joint dislocation, single, with manipulation; requiring anesthesia

CPT4 code

Name of the Procedure:

Closed Treatment of Interphalangeal Joint Dislocation, Single, with Manipulation; Requiring Anesthesia
Common name(s): Finger Joint Realignment, Closed Reduction of Finger Joint Dislocation

Summary

Closed treatment of an interphalangeal joint dislocation is a procedure used to realign a dislocated finger joint without making an incision. This is done through external manipulation and requires anesthesia to ensure the patient is comfortable and pain-free.

Purpose

This procedure addresses dislocations of the finger joints (interphalangeal joints), which can occur due to trauma such as sports injuries, falls, or accidents. The primary goal is to restore the normal alignment of the joint, relieve pain, and ensure proper function and mobility of the finger.

Indications

  • Visible deformity in the finger
  • Difficulty moving the finger
  • Swelling and severe pain in the affected joint
  • Numbness or tingling sensation in the finger
  • Confirmation of dislocation through X-ray or other imaging techniques

Preparation

  • Fasting for a few hours before the procedure if general anesthesia is used
  • Adjustments to current medications as advised by the healthcare provider
  • Pre-procedure X-ray to confirm the dislocation and exclude fractures

Procedure Description

  1. The patient is given anesthesia, which can be local, regional, or general depending on the severity and the patient's condition.
  2. The medical professional will gently manipulate and maneuver the dislocated joint back into its proper position.
  3. Post-manipulation, another X-ray may be conducted to confirm the alignment.
  4. The finger may be immobilized using a splint or buddy taping to the adjacent finger for several weeks to ensure proper healing.

Duration

The procedure typically takes about 20 to 30 minutes, including the time for manipulation and anesthesia administration.

Setting

This procedure can be performed in various settings, including hospital emergency rooms, outpatient clinics, or specialized orthopedic centers.

Personnel

  • Orthopedic surgeon or emergency physician
  • Nurse or medical assistant
  • Anesthesiologist or nurse anesthetist (if general or regional anesthesia is applied)

Risks and Complications

  • Infection at the site of manipulation
  • Blood vessel or nerve injury
  • Joint stiffness or reduced mobility
  • Recurrence of dislocation
  • Pain or swelling that persists

Benefits

  • Immediate pain relief
  • Restoration of normal joint alignment and function
  • Prevention of long-term joint damage or deformity
  • Quick return to daily activities once healed

Recovery

  • The patient may need to wear a splint or buddy tape the finger for 2-4 weeks.
  • Avoid heavy lifting or strenuous activities with the affected hand.
  • Follow-up appointments to monitor healing and ensure the finger retains proper alignment.
  • Gentle finger exercises or physical therapy may be recommended to restore full mobility.

Alternatives

  • Open reduction (surgical intervention) in cases where closed manipulation fails or there are associated fractures
  • Use of pain management strategies and gradual self-reduction (rarely recommended without medical supervision)
  • Long-term splinting without manipulation (may result in suboptimal healing)

Patient Experience

During the procedure, the patient will be under anesthesia and should not feel pain. Post-procedure, they may experience mild discomfort, bruising, and swelling, which can be managed with prescribed pain relievers and anti-inflammatory medication. Keeping the hand elevated and applying ice packs can also reduce swelling and aid in recovery.

Medical Policies and Guidelines for Closed treatment of interphalangeal joint dislocation, single, with manipulation; requiring anesthesia

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