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Open treatment of posterior or anterior acetabular wall fracture, with internal fixation
CPT4 code
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
- The patient is placed under general anesthesia.
- An incision is made over the fractured area to access the bone.
- The surgeon repositions the fractured bone segments.
- Metal screws, plates, or rods are inserted to fix the bones in place.
- The incision is closed with sutures or staples.
- 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