Closed treatment of posterior pelvic ring fracture(s), dislocation(s), diastasis or subluxation of the ilium, sacroiliac joint, and/or sacrum, with or without anterior pelvic ring fracture(s) and/or dislocation(s) of the pubic symphysis and/or superior/in
CPT4 code
Name of the Procedure:
Closed treatment of posterior pelvic ring fracture(s), dislocation(s), diastasis or subluxation of the ilium, sacroiliac joint, and/or sacrum, with or without anterior pelvic ring fracture(s) and/or dislocation(s) of the pubic symphysis and/or superior/in.
Common name(s): Non-surgical treatment of posterior pelvic fractures
Summary
The closed treatment of posterior pelvic ring fractures involves non-surgical methods to stabilize and heal fractures or dislocations of the pelvic bones and joints. This can include using braces, physical therapy, and other supportive measures to ensure proper alignment and healing without the need for surgical intervention.
Purpose
The procedure addresses fractures, dislocations, and misalignments in the pelvic ring. The goal is to stabilize the pelvis, promote healing, alleviate pain, and restore function without invasive surgery.
Indications
- Severe pain or dysfunction due to pelvic fractures or dislocations.
- Evidence of pelvic instability on imaging tests.
- Patients for whom surgery is too risky due to underlying health conditions.
Preparation
- Follow fasting instructions if anesthesia is required.
- Medications may need to be adjusted—consult with your doctor.
- Diagnostic imaging such as X-rays, CT scans, or MRIs to assess the extent of the injury.
Procedure Description
- The patient is positioned appropriately to assess and treat the injury.
- Imaging techniques (like X-rays) are used to guide the alignment process.
- Manual manipulation and/or traction may be applied to reposition dislocated bones.
- Supporting devices such as braces, belts, or external fixators are used to maintain stability.
- Pain management solutions (oral medication, local anesthesia) are provided as needed.
- Regular follow-up imaging to monitor the healing process.
Duration
The initial procedure usually takes 1-2 hours. However, the total treatment time may span several weeks to months of follow-up and rehabilitation.
Setting
The initial treatment is performed in a hospital or surgical center. Follow-up care and rehabilitative therapy typically occur in outpatient settings.
Personnel
- Orthopedic surgeon
- Radiologist
- Nurses
- Physical therapists
Risks and Complications
- Pain or discomfort during manipulation.
- Potential for incomplete healing or misalignment.
- Risk of blood clots.
- Possible complications from immobilization such as muscle wasting or stiffness.
Benefits
- Non-invasive, avoiding the risks associated with surgery.
- Promotes natural healing processes.
- Reduced recovery time compared to surgical options.
- Effective pain management.
Recovery
- Adhere to physical therapy and rehabilitation as instructed.
- Use of assistive devices (crutches, wheelchairs) may be necessary.
- Follow-up appointments to monitor healing via imaging.
- Typical recovery time ranges from 8-12 weeks.
Alternatives
- Open surgical treatment for severe fractures.
- Long-term immobilization without repositioning (less effective and higher risk of complications).
- Cons: Surgery involves higher risk and longer recovery; immobilization alone may not ensure proper healing.
Patient Experience
- Some discomfort or pain during manipulation but managed with painkillers.
- Feeling of tightness or restriction from braces or external devices.
- Gradual improvement in pain and mobility over several weeks.
- Continuous support from healthcare professionals to manage pain and enhance recovery.