Open treatment of hip dislocation, traumatic, without internal fixation
CPT4 code
Name of the Procedure:
Open Treatment of Hip Dislocation, Traumatic, Without Internal Fixation
Common Names: Open Reduction of Hip Dislocation, Hip Relocation Surgery
Summary
Open treatment of a traumatic hip dislocation involves surgically realigning the hip joint after it has been displaced. This procedure does not involve the use of internal metal devices to hold the joint in place.
Purpose
The procedure addresses the condition where the hip joint is forcefully displaced from its normal position due to trauma. The goal is to restore the hip joint to its proper alignment to alleviate pain, restore function, and prevent further damage to the hip joint and surrounding tissues.
Indications
- Severe pain and immobility due to hip dislocation.
- Traumatic injury to the hip joint, often resulting from falls, car accidents, or sports injuries.
- Failure of closed reduction (non-surgical realignment) to successfully reposition the hip.
- Potential nerve or blood vessel damage requiring direct surgical intervention.
Preparation
- Patients may need to fast for several hours prior to surgery.
- Cessation of certain medications (e.g., blood thinners) as instructed by the healthcare provider.
- Preoperative imaging tests, such as X-rays or MRIs, to assess the extent of the dislocation and any associated injuries.
- Pre-surgical evaluation including blood tests and a physical examination.
Procedure Description
- Anesthesia: General anesthesia is administered to ensure the patient is unconscious and pain-free.
- Incision: A surgical incision is made near the hip to access the joint.
- Dislocation Reduction: The surgeon manually manipulates the femoral head back into the acetabulum (hip socket).
- Inspection and Repair: The area is inspected for any damage to the surrounding tissues, nerves, and blood vessels, which are repaired as needed.
- Closure: The surgical site is closed with sutures or staples, and a sterile dressing is applied.
Duration
Typically, the procedure takes about 1-2 hours, depending on the complexity of the dislocation and any additional repairs needed.
Setting
The procedure is performed in a hospital's operating room or a specialized surgical center.
Personnel
- Orthopedic Surgeon
- Anesthesiologist
- Surgical Nurses
- Operating Room Technicians
Risks and Complications
- Infection at the surgical site
- Bleeding or bruising
- Blood clots (deep vein thrombosis)
- Damage to surrounding nerves or blood vessels
- Joint stiffness or reduced range of motion
- Need for further surgery if the hip does not stabilize
Benefits
- Relief from severe pain caused by the dislocation.
- Restoration of hip function and mobility.
- Prevention of long-term damage to the hip joint and surrounding tissues.
- Most patients experience a significant improvement in a few weeks post-surgery.
Recovery
- Hospital stay of a few days may be necessary.
- Pain management with prescribed medications.
- Physical therapy to regain strength and mobility.
- Instructions on weight-bearing restrictions and use of mobility aids like crutches or walkers.
- Follow-up appointments to monitor healing and progress.
- Full recovery may range from several weeks to months, depending on the individual's condition.
Alternatives
- Closed reduction (non-surgical realignment), which is less invasive but may not be effective in all cases.
- Observation and physical therapy for minor dislocations where the joint might stabilize itself.
- Use of hip braces to support joint realignment without surgery.
- Pros and Cons: Non-surgical options carry fewer risks but may not provide a permanent solution, whereas open surgery offers a definitive alignment but with higher risks and longer recovery.
Patient Experience
- During the procedure, the patient will be under general anesthesia and will not feel any pain.
- Post-operatively, pain and swelling are commonly managed with medications.
- Patients may experience discomfort and limited mobility initially, but with rehabilitation, these symptoms typically improve over time.