Search all medical codes
Repair of nonunion or malunion, tibia; with iliac or other autograft (includes obtaining graft)
CPT4 code
Name of the Procedure:
Repair of Nonunion or Malunion, Tibia; with Iliac or Other Autograft (includes obtaining graft)
Summary
This surgical procedure involves fixing a tibia that has not healed properly after a fracture. Surgeons use a piece of bone (autograft) taken from another part of the patient's body, usually the iliac crest (part of the pelvis), to aid in the repair.
Purpose
Medical Condition:
- Nonunion: A broken bone that fails to heal.
- Malunion: A bone that heals in an improper position.
Goals:
- Restore proper alignment and function of the tibia.
- Promote bone healing and stability.
Indications
Symptoms/Conditions:
- Persistent pain at the fracture site.
- Inadequate bone healing seen on X-rays.
- Deformity in the leg.
Patient Criteria:
- Patients with a confirmed diagnosis of nonunion or malunion of the tibia.
- Suitable general health for undergoing surgery.
Preparation
Pre-procedure Instructions:
- Fasting for at least 8 hours before surgery.
- Adjusting medications as per doctor's advice.
- Arrange for transportation and post-surgery care at home.
Tests/Assessments:
- Blood tests and imaging studies (X-rays, CT scans).
- Pre-operative medical evaluation.
Procedure Description
Steps:
- Administer anesthesia to the patient.
- Make an incision over the fracture site on the tibia.
- Clean the fracture ends to stimulate healing.
- Obtain an autograft from the patient’s iliac crest or another suitable site.
- Place the graft into the fracture site to promote bone healing.
- Secure the graft with plates, screws, or rods as necessary.
- Close the incision with sutures or staples.
Tools/Equipment:
- Surgical instruments for bone cutting and grafting.
- Imaging tools for guidance.
- Fixation devices like plates, screws, or rods.
Anesthesia:
- General anesthesia.
Duration
- Typically takes 2 to 4 hours.
Setting
- Hospital or specialized surgical center.
Personnel
- Orthopedic surgeon.
- Anesthesiologist.
- Surgical nurses.
- Surgical technician.
Risks and Complications
Common Risks:
- Infection.
- Bleeding.
- Blood clots.
Rare Risks:
- Nonunion of the graft.
- Damage to nearby nerves or blood vessels.
- Chronic pain.
Benefits
- Proper bone healing and restored function.
- Pain relief and improved mobility.
- Correction of the bone deformity.
Recovery
Post-procedure Care:
- Pain management with medications.
- Keeping the leg elevated to reduce swelling.
- Use of crutches or a walker.
Recovery Time:
- Initial healing takes 6 to 8 weeks.
- Full recovery may take several months.
Restrictions:
- Avoid weight-bearing activities until cleared by the doctor.
- Follow-up appointments for X-rays and wound check.
Alternatives
Other Options:
- External fixation.
- Bone stimulators.
- Conservative management with physical therapy.
Pros and Cons:
- Non-surgical options may take longer to heal and might not fully correct the malunion or nonunion.
- Surgical options provide quicker and more definitive results but come with surgical risks.
Patient Experience
During Procedure:
- Under general anesthesia, so the patient will be asleep and pain-free.
After Procedure:
- Initial pain and discomfort managed with pain relief medications.
- Gradual improvement in leg function and reduction in pain.
- Physical therapy may be required to regain strength and mobility.