27216 Percutaneous skeletal fixation of posterior pelvic bone fracture and/or dislocation, for fracture patterns that disrupt the pelvic ring, unilateral (includes ipsilateral ilium, sacroiliac joint and/or sacrum)

Name of the Procedure:

Percutaneous Skeletal Fixation of Posterior Pelvic Bone Fracture and/or Dislocation

Summary

This minimally invasive surgical procedure involves stabilizing a fractured or dislocated posterior pelvic bone, particularly in cases where the pelvic ring is disrupted. The process uses small incisions and imaging guidance to insert screws or pins to fix the bones in place.

Purpose

To treat pelvic fractures and dislocations that compromise the stability of the pelvic ring. The goal is to restore proper alignment and stability to the pelvis, facilitate healing, and enable the patient to regain normal function and mobility.

Indications

• Unilateral fractures of the pelvis involving ipsilateral ilium, sacroiliac joint, and/or sacrum.
• Pelvic instability or high-energy trauma impacting the pelvic ring.
• Severe pain, difficulty in weight-bearing, or mobility due to pelvic fractures.

Preparation

• Patient will typically need to fast for 6-8 hours before the procedure.
• Anticoagulant medications may need to be adjusted or stopped.
• Imaging studies such as X-rays, CT scans, or MRIs are required to assess the injury.

Procedure Description

1. Patient is positioned, usually under general anesthesia.
2. Small incisions are made over the fracture site.
3. Using fluoroscopic (real-time X-ray) guidance, guidewires are inserted into the bone.
4. Screws or pins are then placed along the guidewires to stabilize the bone fragments.
5. Incisions are closed and dressed.

Duration

The procedure typically takes 1 to 2 hours, depending on the complexity of the fracture.

Setting

Performed in a hospital surgical suite.

Personnel

• Orthopedic surgeon
• Surgical nurses
• Anesthesiologist
• Radiologic technologist

Risks and Complications

• Infection at the incision site
• Bleeding or hematoma formation
• Nerve or vascular injury
• Failure of fixation hardware
• Non-union or malunion of the fracture
• Deep vein thrombosis (DVT)

Benefits

• Minimally invasive with smaller incisions and faster recovery.
• Enhanced stabilization of the pelvis for better healing.
• Reduced pain and improved mobility post-surgery.
• Shorter hospital stay compared to open procedures.

Recovery

• Patients may need to limit weight-bearing activities for a period as directed by their surgeon.
• Physical therapy may be recommended for rehabilitation.
• Typical recovery time ranges from a few weeks to several months.
• Follow-up appointments will be necessary to monitor healing.

Alternatives

• Non-surgical management with bed rest and pain control.
• Open surgical fixation, which involves larger incisions and longer recovery.
• Each alternative has its pros and cons in terms of recovery time, risks, and effectiveness.

Patient Experience

• During the procedure, the patient will be under anesthesia and will not feel pain.
• Post-procedure, patients may experience soreness or mild pain at the incision site, managed with pain medications.
• Full recovery varies, with most interventions aimed at ensuring patient comfort and proper guidance on mobility and rehabilitation.