Name of the Procedure:

Closed Treatment of Tibial Shaft Fracture (with or without Fibular Fracture); Without Manipulation

Summary

This procedure involves the non-surgical treatment of a fractured tibial shaft (the long bone in the lower leg) without physically setting or realigning the bone, even if there is an additional fibular fracture (the smaller bone in the lower leg).

Purpose

This procedure is designed to stabilize a broken tibia and allow it to heal naturally without the need for surgical intervention. The goal is to ensure proper alignment and healing of the bone while minimizing discomfort and restoring function to the leg.

Indications

• Acute pain and swelling in the lower leg due to a recent injury.
• X-ray confirmation of a tibial shaft fracture, with or without an accompanying fibular fracture.
• Patients who are not good candidates for surgery due to health conditions, age, or personal preference.

Preparation

• Initial assessment and diagnostic imaging (such as X-rays).
• Patients may be advised to avoid eating or drinking for a short period before the procedure if any sedation is required.
• Review of the patient's medical history and any current medications.

Procedure Description

1. The patient is positioned comfortably, usually lying flat with the affected leg supported.
2. Immobilization devices, such as a splint or cast, are applied to stabilize the leg.
3. The healthcare provider ensures that the bones are aligned correctly through gentle external manipulation, if necessary.
4. No invasive maneuvers or incisions are made.

Duration

The procedure itself typically takes 30 minutes to 1 hour.

Setting

This procedure is usually performed in an outpatient clinic, emergency room, or hospital setting.

Personnel

• Orthopedic surgeon or fracture specialist
• Registered nurse
• Radiology technician (for imaging)

Risks and Complications

• Improper alignment leading to malunion or nonunion of the bone.
• Complications such as deep vein thrombosis (DVT) or pressure sores from the cast.
• Potential for compartment syndrome if swelling within the cast is excessive.

Benefits

• Non-surgical option with lower risk of infection.
• Quicker recovery time compared to surgical intervention.
• Reduced medical costs and hospital stays.

Recovery

• Follow-up appointments to monitor healing via X-rays.
• Instructions on how to care for the cast, including keeping it dry and clean.
• Physical activity restrictions to avoid putting weight on the injured leg.
• Rehabilitation exercises or physical therapy to regain strength and mobility.

Alternatives

• Open reduction and internal fixation (surgical realignment with screws/plates).
• External fixation (using a metal frame outside the body).
• Pros of alternatives may include more precise bone alignment and faster healing; cons may involve higher infection risk and longer hospital stays.

Patient Experience

• During the procedure, the patient may feel discomfort but little to no pain, especially if sedation or local anesthesia is used.
• Post-procedure, the patient may experience swelling, mild pain, and the inconvenience of wearing a cast.
• Pain management typically involves over-the-counter pain relievers and elevation of the leg to reduce swelling.