27217 Open treatment of anterior pelvic bone fracture and/or dislocation for fracture patterns that disrupt the pelvic ring, unilateral, includes internal fixation, when performed (includes pubic symphysis and/or ipsilateral superior/inferior rami)

Name of the Procedure:

Open Treatment of Anterior Pelvic Bone Fracture and/or Dislocation with Internal Fixation

Summary

This procedure involves surgically repairing fractures or dislocations of the anterior part of the pelvis using internal fixation devices like screws and plates. It is performed to stabilize the pelvic bones and ensure proper alignment for healing.

Purpose

The procedure is designed to treat severe fractures or dislocations of the pelvic bones that have disrupted the pelvic ring. The primary goal is to re-align and stabilize the bones to promote proper healing and restore function, reducing pain and preventing long-term complications.

Indications

• Severe pelvic fractures causing instability or displacement of the bones.
• Dislocation of the pelvic bones affecting the pelvic ring.
• Fractures involving the pubic symphysis and/or superior/inferior rami.
• Patients experiencing significant pain, immobility, or internal bleeding due to pelvic fractures.

Preparation

• Fasting for at least 8 hours before surgery.
• Discontinuing certain medications as advised by the doctor.
• Preoperative imaging studies such as X-rays, CT scans, or MRIs to assess the extent of the fracture.
• Blood tests and other routine medical evaluations.

Procedure Description

1. The patient is placed under general anesthesia.
2. An incision is made over the affected area of the pelvis.
3. The surgeon carefully repositions the fractured or dislocated bones.
4. Internal fixation devices like screws, plates, or rods are used to secure the bones in their proper alignment.
5. The incision is closed with sutures or staples, and a sterile dressing is applied.

Duration

The procedure typically takes 2 to 4 hours, depending on the complexity of the fracture.

Setting

Open treatment of anterior pelvic bone fracture is generally performed in a hospital operating room.

Personnel

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

Risks and Complications

• Infection at the surgical site
• Bleeding or blood clots
• Injury to surrounding tissues or organs
• Nerve damage
• Hardware-related issues (e.g., loosening or breakage of screws/plates)
• Delayed or improper bone healing

Benefits

• Stable and properly aligned pelvic bones
• Reduced pain and discomfort
• Improved mobility and function
• Prevention of long-term complications such as chronic pain or deformity

Recovery

• Initial hospital stay of 3-5 days for monitoring and pain management.
• Pain medications and antibiotics as prescribed.
• Physical therapy to regain strength and mobility.
• Limited weight-bearing activities for several weeks.
• Follow-up appointments for X-rays and progress assessment.

Alternatives

• Non-surgical treatment with bed rest and pain management (suitable for less severe cases).
• Percutaneous fixation, a less invasive procedure for certain fracture types.
• Pros and Cons: Non-surgical treatment may result in longer recovery time and potential for improper healing, while percutaneous fixation has a faster recovery but may not be suitable for all fracture types.

Patient Experience

During the procedure, the patient will be under general anesthesia and will not feel pain. Postoperatively, pain and discomfort are managed with medications. Some swelling and bruising are normal, and patients may initially require assistance with daily activities. Full recovery can take several months, but physical therapy helps regain strength and normal function.