27226 Open treatment of posterior or anterior acetabular wall fracture, with internal fixation

Name of the Procedure:

Open Treatment of Posterior or Anterior Acetabular Wall Fracture with Internal Fixation

Summary

This surgical procedure involves making an incision in the hip area to access and repair a fractured part of the acetabulum (the socket of the hip joint). Metal screws or plates are used to stabilize the bone, facilitating proper healing.

Purpose

Medical Condition:

• Acetabular Wall Fracture

Goals:

• Realign and stabilize the fractured bone segments
• Restore normal hip function
• Prevent complications such as arthritis or hip dislocation

Indications

Symptoms or Conditions:

• Severe hip pain
• Inability to bear weight on the affected leg
• Hip instability or dislocation

Patient Criteria:

• Diagnosed acetabular wall fracture (via X-ray or CT scan)
• Failure of conservative treatments like rest or physical therapy

Preparation

Pre-procedure Instructions:

• Fast for 8-12 hours prior to surgery
• Adjust or discontinue certain medications (as advised by a doctor)
• Arrange for post-operative transportation and assistance

Diagnostic Tests:

• Physical examination
• Imaging studies (X-rays, CT scans)
• Blood tests and other baseline assessments

Procedure Description

1. The patient is placed under general anesthesia.
2. An incision is made over the fractured area to access the bone.
3. The surgeon repositions the fractured bone segments.
4. Metal screws, plates, or rods are inserted to fix the bones in place.
5. The incision is closed with sutures or staples.
6. A sterile dressing is applied to the surgical site.

Tools & Equipment:

• Surgical scalpel
• Metal screws, plates, or rods
• Surgical drill
• Sutures or staples

Anesthesia:

• General anesthesia to ensure the patient is asleep and pain-free

Duration

• Typically takes 2 to 3 hours, depending on the complexity of the fracture

Setting

• Performed in a hospital or specialized surgical center

Personnel

• Orthopedic surgeon
• Anesthesiologist
• Surgical nurse
• Surgical technologist

Risks and Complications

Common Risks:

• Infection
• Bleeding
• Blood clots

Rare Complications:

• Nerve or blood vessel damage
• Implant failure or breakage
• Non-union or mal-union of the fracture

Management:

• Antibiotics for infection
• Pain management
• Physical therapy post-surgery

Benefits

• Improved hip stability
• Reduced pain and discomfort
• Enhanced mobility and function
• Lower risk of arthritis and hip dislocation

Realization Timeline:

• Benefits begin to be noticeable within a few weeks post-surgery, with full recovery within several months

Recovery

Post-procedure Care:

• Follow prescribed pain management regimen
• Keep the surgical site clean and dry
• Attend physical therapy sessions

Expected Recovery Time:

• Initial recovery: 6-8 weeks
• Complete recovery: 6-12 months

Restrictions and Follow-up:

• Avoid weight-bearing activities initially
• Routine follow-up appointments for monitoring progress

Alternatives

Other Treatment Options:

• Non-surgical management (e.g., traction, brace)
• Minimally invasive surgery

Pros and Cons:

• Non-surgical options might not fully stabilize the fracture.
• Minimally invasive options might be suitable for less severe fractures but not for complex cases.

Patient Experience

During the Procedure:

• No sensations or pain due to general anesthesia

After the Procedure:

• Post-surgical pain managed with medication
• Discomfort and limited mobility initially
• Gradual improvement with physical therapy and proper care

Pain Management and Comfort:

• Medications prescribed for pain relief
• Ice packs may be used to reduce swelling
• Gradual return to normal activities as advised by the healthcare team