27514 Open treatment of femoral fracture, distal end, medial or lateral condyle, includes internal fixation, when performed

Name of the Procedure:

Open Treatment of Femoral Fracture, Distal End (Medial or Lateral Condyle) with Internal Fixation

Summary

This surgical procedure involves the open treatment of a fracture located at the distal end of the femur, specifically in the medial or lateral condyle. This is achieved through a surgical incision and the use of internal fixation devices such as screws, plates, or rods to stabilize and heal the bone.

Purpose

The procedure addresses fractures in the distal end of the femur, specifically at the medial or lateral condyle. The goals are to properly align the bone fragments, facilitate stable healing, relieve pain, restore function, and prevent complications such as arthritis.

Indications

• Severe pain and inability to move the leg or bear weight
• Visible deformity or swelling at the fracture site
• X-rays or other imaging showing a displaced or unstable fracture of the femoral condyle
• Patients typically include individuals with high-energy trauma (e.g., accidents) or those with weakened bone health (e.g., osteoporosis).

Preparation

• Patients may be required to fast for 8 hours before surgery.
• Medications like blood thinners might need to be discontinued under doctor guidance.
• Preoperative tests such as blood work, ECG, and imaging (X-rays, CT scans) are conducted to plan the surgery and ensure the patient is fit for anesthesia.

Procedure Description

1. Anesthesia: The patient is given general anesthesia or regional anesthesia.
2. Incision: A surgical incision is made over the fracture site.
3. Exposure: The soft tissues are meticulously retracted to expose the fracture.
4. Reduction: The bone fragments are realigned to their anatomical position.
5. Internal Fixation: Plates, screws, or rods are applied to stabilize the fracture internally.
6. Closure: The incision is closed with sutures or staples, and a sterile dressing is applied.

Duration

The procedure typically takes around 2 to 3 hours, depending on the complexity of the fracture.

Setting

The procedure is performed in a hospital operating room.

Personnel

• Orthopedic surgeon
• Surgical team, including surgical technologists and orthopedic nurses
• Anesthesiologist
• Radiologic technologist (for intraoperative imaging, if needed)

Risks and Complications

• Infection
• Bleeding or hematoma
• Blood clots (Deep Vein Thrombosis)
• Non-union or malunion of the fracture
• Damage to surrounding nerves or blood vessels
• Possible allergic reaction to anesthesia

Benefits

• Proper alignment and stabilization of the fracture
• Reduced pain and improved function
• Lower risk of future arthritis or deformity
• Quicker return to normal activities with appropriate rehabilitation

Recovery

• Initial postoperative care includes pain management, antibiotics for infection prevention, and immobilization of the leg.
• Physical therapy begins a few days post-surgery to enhance mobility and strength.
• Full recovery can take several months, depending on the fracture severity and patient health, with considerations for weight-bearing restrictions and regular follow-up visits.

Alternatives

• Non-surgical treatment with casting or bracing (less effective for displaced fractures)
• External fixation (used mainly for complex or open fractures)
• Each alternative has its pros and cons, such as lower surgical risks but potentially longer recovery and less effective fracture stabilization.

Patient Experience

Patients will be under anesthesia during the procedure, experiencing no pain. Postoperatively, they may experience discomfort managed by pain relief measures. Swelling and bruising are expected, and mobility aids like crutches might be necessary. Rehabilitation support will gradually restore function and strength.