Name of the Procedure:

Closed Treatment of Supracondylar or Transcondylar Femoral Fracture with or without Intercondylar Extension, without Manipulation

Summary

This procedure involves treating a fracture in the lower part of the femur (thigh bone) near the knee joint without needing to reposition (manipulate) the broken bone pieces and without making any surgical incisions.

Purpose

The procedure addresses fractures of the distal femur (the far end of the thigh bone). The goal is to allow the bone to heal naturally without surgical intervention while ensuring it stays in a stable position. Expected outcomes include proper bone healing, restoration of function, and minimized pain.

Indications

• Fractures resulting from trauma (e.g., falls, car accidents) that are stable and do not require realignment.
• Patients who have fractures that can heal without surgical intervention.
• Individuals with contraindications for surgery or those who prefer non-surgical options.

Preparation

• Follow instructions regarding fasting if anesthesia is to be used.
• Inform the doctor about any medications, as some may need to be paused (e.g., blood thinners).
• Pre-procedure assessments, including X-rays or CT scans, to determine fracture stability.

Procedure Description

1. The patient is usually sedated or given anesthesia to ensure comfort.
2. The affected leg is carefully placed in a cast or brace to immobilize the fracture.
3. The cast or brace supports the bone in its current position, allowing natural healing.
4. Imaging may confirm the correct placement of the immobilization device.
5. Regular follow-up X-rays will be scheduled to monitor the healing process.

Duration

The procedure itself, including preparation, generally takes about 1-2 hours. Actual casting takes around 15-30 minutes.

Setting

This procedure is typically performed in a hospital, outpatient clinic, or orthopedic specialist's office.

Personnel

• Orthopedic specialists or surgeons
• Nursing staff
• Radiology technicians (for imaging)
• Anesthesiologists (if sedation or anesthesia is used)

Risks and Complications

• Skin irritation or sores under the cast
• Compartment syndrome (rare, serious condition of increased pressure)
• Cast loosening or damage
• Potential for bone misalignment if not properly monitored
• Prolonged immobilization complications like stiffness or muscle atrophy

Benefits

• Non-invasive method avoids surgical risks
• Promotes natural bone healing
• Reduced hospital stay and quicker return to normal activities
• Lesser chance of infection compared to surgical methods

Recovery

• Regular monitoring with X-rays to assess healing.
• Follow-up appointments for cast assessment and removal, typically after 6-8 weeks.
• Physical therapy may be recommended post-immobilization to regain strength and mobility.
• Avoid weight-bearing activities on the affected leg until cleared by the physician.

Alternatives

• Open Reduction and Internal Fixation (ORIF) involving surgical realignment and stabilization with hardware.
  • Pros: Direct visualization and alignment of fracture; quicker mobilization.
  • Cons: Surgical risks such as infection, blood loss, and longer recovery.
• External Fixation using a frame outside the body to stabilize the bone.
  • Pros: Minimally invasive compared to internal surgery; adjustable.
  • Cons: Risk of pin site infections and discomfort.

Patient Experience

• The patient may feel discomfort during cast application.
• Mild pain post-procedure, usually manageable with over-the-counter pain relief.
• Temporary restrictions in movement and activities.
• Some patients report itching or discomfort under the cast.
• Physical limitations but can resume normal activities gradually as healing progresses and per doctor’s advice.