Name of the Procedure:

Percutaneous Skeletal Fixation of Interphalangeal Joint Dislocation, Single, with Manipulation

Summary

In this procedure, a dislocated joint in the finger is realigned and stabilized using minimally invasive techniques. This involves manually manipulating the joint back into position and using small pins, wires, or screws to keep it stable as it heals.

Purpose

The procedure addresses dislocations of the interphalangeal joints, which are the hinge joints in the fingers. The goal is to restore proper alignment and function, reduce pain, and prevent further damage or instability in the joint.

Indications

• Severe pain and deformity in the finger due to dislocation
• Inability to move the finger normally
• Failed conservative treatments such as splinting or physical therapy
• Acute injury or trauma to the finger joints

Preparation

• Complete a physical examination and review medical history.
• X-rays or other imaging tests to assess the extent of the dislocation.
• Fasting may be required if general anesthesia is used.
• Adjustments to current medications as advised by the healthcare provider.

Procedure Description

1. The patient is given local anesthesia to numb the area, though sometimes general anesthesia is used.
2. The surgeon manually manipulates the dislocated joint back into its correct position.
3. Using fluoroscopy (live X-ray imaging) to guide the placement, the surgeon inserts small pins, wires, or screws through the skin and into the bones to stabilize the joint.
4. These instruments are left in place for several weeks to ensure proper healing.

Duration

The procedure typically takes around 30 minutes to an hour.

Setting

The procedure is generally performed in an outpatient surgical center or a hospital.

Personnel

• Orthopedic surgeon
• Surgical nurse
• Radiologic technologist
• Anesthesiologist (if general anesthesia is used)

Risks and Complications

• Infection at the pin sites
• Nerve or blood vessel damage
• Improper alignment or stability of the joint
• Allergic reactions to anesthesia
• Stiffness or reduced range of motion in the finger

Benefits

• Relieves pain and restores normal alignment
• Allows for the proper healing of the joint
• Reduces the risk of further injury or complications
• Increased function and range of motion in the finger

Recovery

• Finger splint or cast to protect the joint and supporting hardware.
• Light activities might resume within a week, but avoid heavy use of the hand.
• Regular follow-up appointments to monitor healing and remove pins.
• Physical therapy may be recommended to regain strength and motion.
• Full recovery may take several weeks to a few months.

Alternatives

• Non-surgical treatment like splinting and physical therapy for less severe dislocations.
• Surgical open reduction if the joint cannot be realigned through manipulation.
• Each alternative has its own pros and cons, such as longer recovery times or less effective outcomes in severe cases.

Patient Experience

Patients may feel some pressure or discomfort during manipulation, though anesthesia will mitigate pain. Post-procedure, there may be mild pain and swelling managed with medication. Discomfort typically lessens as healing progresses. Regular follow-ups and adherence to recovery instructions are crucial for successful outcomes.