27503 Closed treatment of supracondylar or transcondylar femoral fracture with or without intercondylar extension, with manipulation, with or without skin or skeletal traction

Name of the Procedure:

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

Summary

This procedure involves non-surgical (closed) treatment of a fractured femur just above or through the knee joint. It may include physical manipulation to realign the bone and the application of traction to maintain alignment during healing.

Purpose

Medical Condition: Supracondylar or transcondylar femoral fractures. Goals: Realigning the broken bone, promoting proper bone healing, and restoring function to the leg and knee.

Indications

Symptoms/Conditions:

• Severe pain in the thigh or knee following trauma.
• Swelling, bruising, or visible deformity around the knee.
• Inability to move or bear weight on the affected leg. Patient Criteria:
• Suitable for non-surgical treatment.
• Fracture type amenable to closed treatment.

Preparation

Pre-Procedure Instructions:

• Fasting if sedation is planned.
• Adjustments to medications, particularly blood thinners. Diagnostic Tests:
• Imaging studies such as X-rays, CT scans, or MRIs to assess the fracture.

Procedure Description

1. The patient is positioned to allow access to the fractured femur.
2. Sedation or anesthesia may be administered for pain management.
3. The physician manually manipulates the leg to align the fractured bones.
4. Skin or skeletal traction is applied to maintain bone alignment during healing.
5. The leg may be immobilized with a cast or brace. Tools/Equipment: Traction devices, immobilizers, X-ray imaging. Anesthesia: Local, regional, or general anesthesia depending on the case.

Duration

The procedure typically takes 1 to 2 hours.

Setting

It is performed in a hospital or surgical center, often in an emergency or orthopedic department.

Personnel

• Orthopedic surgeon or trauma specialist.
• Nurses.
• Anesthesiologist (if sedation or general anesthesia is used).

Risks and Complications

Common Risks:

• Pain during and after the procedure.
• Swelling and bruising. Rare Risks:
• Infection.
• Poor bone healing or misalignment requiring surgical intervention.
• Compartment syndrome. Management: Regular monitoring and potential surgical intervention if complications arise.

Benefits

Expected Benefits:

• Proper alignment of the femur for natural healing.
• Reduced pain and improved function. Realization Time: Benefits are typically seen as bone healing progresses, usually within weeks to months.

Recovery

Post-Procedure Care:

• Pain management with medications.
• Physical therapy to regain strength and mobility.
• Regular follow-up appointments for X-rays to monitor healing. Recovery Time: Several weeks to months, depending on the fracture's severity and the patient's overall health. Restrictions: Limited weight-bearing on the affected leg until cleared by a physician.

Alternatives

Other Options:

• Surgical treatment with internal fixation.
• Non-invasive methods like functional bracing without manipulation. Pros and Cons: Surgical options may offer quicker stabilization but come with higher risks and longer hospital stays.

Patient Experience

During the Procedure:

• Anesthesia will minimize pain. After the Procedure:
• Some discomfort and swelling are expected.
• Pain managed with medications. Comfort Measures:
• Elevation of the leg.
• Ice application to reduce swelling.
• Regular pain assessments and adjustments to pain management strategies.