27538 Closed treatment of intercondylar spine(s) and/or tuberosity fracture(s) of knee, with or without manipulation

Name of the Procedure:

Closed Treatment of Intercondylar Spine(s) and/or Tuberosity Fracture(s) of Knee, with or without Manipulation

Summary

This procedure involves the non-surgical (closed) treatment of fractures in the knee's intercondylar spine or tuberosity. Sometimes, manipulation may be necessary to properly align the bone fragments.

Purpose

This procedure aims to treat fractures in specific parts of the knee to ensure proper healing and restore full function. The goal is to realign and stabilize the knee structures without the need for open surgery.

Indications

• Acute pain and swelling in the knee following trauma
• Inability to bear weight on the affected leg
• Misalignment, instability, or deformity of the knee
• Confirmed fractures of the intercondylar spine or tuberosity on imaging tests (X-rays, MRI)

Preparation

• Fasting might not be necessary unless sedation is planned
• Review of current medications and possible adjustments
• Pre-procedure imaging such as X-rays or MRIs to evaluate the fracture

Procedure Description

1. The patient is positioned to allow optimal access to the knee.
2. Depending on the case, local anesthesia, regional anesthesia, or mild sedation may be administered.
3. The healthcare provider manipulates the knee to align the bone fragments properly, if necessary.
4. Immobilization of the knee using a cast, brace, or splint.
5. Follow-up imaging may be taken to confirm proper alignment.

Duration

The procedure typically takes 30 to 60 minutes.

Setting

The procedure is usually performed in a hospital, outpatient clinic, or surgical center.

Personnel

• Orthopedic surgeon or specialist
• Nurse or medical assistant
• Anesthesiologist (if sedation is used)

Risks and Complications

• Pain and swelling
• Inadequate alignment or healing of the fracture
• Infection
• Blood clots
• Nerve damage
• Compartment syndrome (rare)

Benefits

• Non-surgical approach with reduced recovery time
• Lesser pain and discomfort compared to open surgery
• Potential for full recovery and regain of knee function

Recovery

• Immediate application of a cast or brace for knee immobilization
• Pain management with prescribed medications
• Regular follow-up appointments and imaging to monitor healing
• Physical therapy may be recommended once the fracture starts healing
• Typical recovery time ranges from 6 to 12 weeks, depending on the extent of the fracture

Alternatives

• Open surgical treatment to directly visualize and fix the fracture
  • Pros: Direct access to fracture, possibly better alignment
  • Cons: Higher risks, longer recovery time, more invasive

Patient Experience

• During the procedure: Minimal discomfort if sedation or local anesthesia is used; may feel pressure during manipulation
• After the procedure: Soreness and swelling managed with medication; immobilization of the knee; possible physical therapy sessions

Pain management and comfort measures will be discussed, and the healthcare team will ensure the patient is as comfortable as possible throughout the process.