Open treatment of femoral supracondylar or transcondylar fracture without intercondylar extension, includes internal fixation, when performed
CPT4 code
Name of the Procedure:
Open treatment of femoral supracondylar or transcondylar fracture without intercondylar extension, includes internal fixation when performed.
Summary
This surgical procedure involves making an incision to access and repair a broken lower thigh bone (femur) just above the knee joint. Metal screws, plates, or rods are used to internally stabilize the bone for proper healing.
Purpose
The procedure addresses fractures in the lower part of the femur (thigh bone) close to the knee. It aims to realign and stabilize the bone to ensure proper healing and restore function to the leg.
Indications
- Severe pain and inability to move the leg due to the fracture.
- Bones that are misaligned (displaced fracture).
- Inadequate healing from non-surgical treatment methods.
- Open fractures where the bone has pierced the skin.
Preparation
- Fasting typically required for at least 6-8 hours before the procedure.
- Blood tests, imaging studies (X-rays, MRI, or CT scans), and possibly a pre-operative medical evaluation.
- Cessation of certain medications as advised by the doctor (e.g., blood thinners).
Procedure Description
- The patient is placed under general anesthesia.
- A surgical incision is made near the fracture site.
- The bones are realigned.
- Metal hardware (screws, plates, or rods) is used to internally fix and stabilize the bones.
- The incision is closed with sutures or staples.
- A sterile dressing is applied to the wound.
Duration
The procedure typically takes 2 to 4 hours, depending on the complexity of the fracture.
Setting
The procedure is performed in a hospital operating room.
Personnel
- Orthopedic surgeon
- Anesthesiologist
- Surgical nurses and technicians
- Radiologic technologist (if intraoperative imaging is needed)
Risks and Complications
- Infection
- Blood clots
- Nerve or blood vessel damage
- Implant failure or irritation
- Delay in bone healing or nonunion
- Stiffness or reduced range of motion in the affected knee
Benefits
- Proper alignment and stabilization of fractured bones.
- Improved functional outcome and mobility.
- Decreased pain once healed.
- Better chance of a full recovery compared to non-surgical methods.
Recovery
- Hospital stay for a few days post-surgery.
- Pain management with prescribed medications.
- Physical therapy to regain strength and mobility.
- Use of crutches or a walker initially; gradual return to weight-bearing activities.
- Regular follow-up appointments to monitor healing.
- Full recovery may take several months.
Alternatives
- Non-surgical treatments such as casting or bracing, but these are less effective for severe fractures.
- External fixation with a frame outside the body, used in some cases.
- The choice of treatment depends on factors like the fracture severity, patient health, and activity level.
Patient Experience
- Anesthesia will ensure the patient feels no pain during the operation.
- Post-surgery discomfort managed with painkillers.
- Possible swelling and bruising around the surgical site.
- Gradual improvement expected with adherence to rehabilitation protocols.
Pain management and comfort measures comprise medications, elevation of the limb, and cold therapy to reduce swelling.