27520 Closed treatment of patellar fracture, without manipulation

Name of the Procedure:

Closed Treatment of Patellar Fracture, Without Manipulation
Common name: Non-manipulative treatment of broken kneecap

Summary

This procedure involves treating a broken kneecap (patella) without adjusting or repositioning the bone fragments. It typically involves immobilization using a cast, brace, or splint to allow the bone to heal naturally.

Purpose

This procedure addresses a patellar fracture, aiming to stabilize the knee and promote natural healing of the bone without surgical intervention. The expected outcome is the proper healing of the patella, restoring normal knee function and relieving pain.

Indications

• Acute knee pain following an injury
• Swelling or bruising around the knee
• Inability to straighten the knee or walk
• X-rays confirming a non-displaced patellar fracture

Preparation

• No specific fasting or medication adjustments typically required
• Diagnostic imaging (X-rays, possibly MRI) to assess the fracture
• Physical examination to evaluate the extent of the injury

Procedure Description

1. The patient is positioned comfortably, usually seated or lying down.
2. A healthcare professional applies a splint, cast, or brace to immobilize the knee.
3. The device is carefully secured to ensure the knee remains stable.
4. Instructions for care and follow-up appointments are provided.

Duration

The application of the immobilizing device typically takes about 15-30 minutes.

Setting

This procedure is usually performed in an outpatient setting, such as a doctor's office, urgent care clinic, or emergency room.

Personnel

• Orthopedic surgeon or physician
• Nurse or medical assistant

Risks and Complications

• Minor risk of skin irritation or pressure sores from the immobilizing device
• Possible stiffness or muscle atrophy due to prolonged immobilization
• Rare risk of blood clots in the leg

Benefits

• Non-invasive treatment method
• Reduced pain and swelling
• Allows natural healing without surgical risks
• Effective stabilization of the fracture

Recovery

• Follow-up visits to monitor healing progress (typically every few weeks)
• Instructions to keep the immobilizing device dry and clean
• Limited weight-bearing and activity (use of crutches if necessary)
• Physical therapy might be recommended once the fracture has healed, to restore strength and mobility

Alternatives

• Surgical treatment if the fracture is displaced or unstable
  • Pros: Direct realignment of bone fragments
  • Cons: Surgical risks, longer recovery time
• Functional bracing and early mobilization
  • Pros: Maintains some knee function; faster return to activities
  • Cons: Potential for improper healing if not carefully monitored

Patient Experience

• The patient might feel discomfort from the immobilizing device initially.
• Pain is usually managed with over-the-counter pain relievers.
• Follow guidance on ice application, medication, and activity limitations.
• Improved comfort and mobility as healing progresses.