27177 Open treatment of slipped femoral epiphysis; single or multiple pinning or bone graft (includes obtaining graft)

Name of the Procedure:

Open treatment of slipped femoral epiphysis; single or multiple pinning or bone graft (includes obtaining graft)

Summary

In this surgical procedure, doctors treat a slipped femoral epiphysis, a condition where the ball at the head of the femur (thigh bone) slips off the neck of the bone. Surgeons use pins or screws to secure the bone in place, and in some cases, they may also use a bone graft to ensure proper healing and stability.

Purpose

The procedure addresses slipped femoral epiphysis, a condition mainly affecting adolescents, causing hip pain and difficulty walking. The goal is to prevent further slipping, alleviate pain, and restore normal function and stability to the hip joint.

Indications

• Adolescents with hip pain and difficulty walking
• Diagnosed slipped femoral epiphysis via imaging studies
• Failure of conservative treatments (e.g., rest, physical therapy)
• Signs of the condition worsening, such as increased pain or reduced mobility

Preparation

• Patients may need to fast for several hours before the procedure.
• Adjustments to current medications, especially blood thinners, may be necessary.
• Pre-operative imaging studies and assessments are required.
• Patients should arrange for transportation and post-operative care.

Procedure Description

1. The patient is positioned and administered anesthesia, typically general anesthesia.
2. An incision is made near the hip area to expose the affected bone.
3. The slipped femoral epiphysis is carefully realigned.
4. Pins or screws are inserted to secure the bone in place.
5. If needed, a bone graft is taken from another part of the patient’s body and placed in the affected area.
6. The incision is closed with sutures or staples, and a dressing is applied.

Duration

The procedure typically takes 1 to 2 hours, but the duration may vary based on specific circumstances.

Setting

This surgery is performed in a hospital or surgical center with appropriate facilities and equipment.

Personnel

• Orthopedic surgeon
• Anesthesiologist
• Surgical nurses
• Operating room technicians

Risks and Complications

• Infection at the surgical site
• Blood clots
• Damage to surrounding nerves or blood vessels
• Failure of the bone to heal properly
• Pain or discomfort at the graft site
• Need for further surgery if complications arise

Benefits

• Stabilization of the hip joint
• Pain relief
• Improved mobility and function
• Prevention of further slippage and complications

Recovery

• Patients may need to use crutches or a walker initially.
• Pain management with prescribed medications.
• Physical therapy to regain strength and mobility.
• Follow-up appointments for monitoring and possible removal of hardware.
• Full recovery may take several months, with restrictions on weight-bearing activities.

Alternatives

• Non-surgical treatments like activity modification or physical therapy (often less effective for severe cases).
• In situ pinning (a less invasive pinning technique, suitable for less severe cases).
• The pros of the open treatment include more secure fixation and comprehensive correction, while cons involve higher risks and longer recovery compared to less invasive methods.

Patient Experience

During the procedure, the patient will be under general anesthesia and unaware of the surgery. Post-surgery, there will be some pain and discomfort managed by medication. Physical therapy and gradual return to normal activities will be necessary. The overall focus is on ensuring comfort and a successful recovery trajectory.