Name of the Procedure:

Closed Treatment of Posterior Malleolus Fracture; Without Manipulation
Common names: Non-surgical treatment of ankle fracture, Conservative management of posterior malleolus fracture.

Summary

This procedure involves treating a fracture at the back part of the ankle (posterior malleolus) without requiring surgery or manipulation of the bone. A cast or a splint is typically applied to stabilize the fracture and allow it to heal naturally.

Purpose

The main goal is to allow a fractured posterior malleolus to heal correctly without causing further damage or deformity. The procedure aims to relieve pain, restore the function of the ankle, and prevent future complications.

Indications

• Fracture in the posterior part of the ankle bone.
• Stable fracture without significant displacement.
• Patients who are not candidates for surgery due to medical conditions or personal preference.

Preparation

• The patient may need to undergo X-rays or other imaging tests to confirm the fracture and its extent.
• Fasting or other specific preparations are generally not required.
• Patients should inform their healthcare provider about any medications they are taking.

Procedure Description

1. Initial Assessment: The healthcare provider examines the fracture with the help of imaging tests.
2. Immobilization: The ankle is placed in a splint or cast to stabilize the fracture and allow it to heal naturally.
3. Instructions: The patient is given instructions on how to care for the cast and what activities to avoid.

No anesthesia or sedation is typically necessary since the fracture is not being manipulated.

Duration

The initial treatment visit may take about 30 to 60 minutes, but follow-up appointments are necessary to monitor healing.

Setting

The procedure is typically performed in an outpatient clinic or an emergency department.

Personnel

• Primary care physician or orthopedic specialist: To diagnose and treat the fracture.
• Nurses: To assist with the application of the cast and provide instructions for care.

Risks and Complications

• Common Risks: Swelling, discomfort, or cast-related issues like pressure sores.
• Rare Complications: Improper healing, infection, or chronic pain.

Benefits

• Allows natural healing of the fracture.
• Avoids surgical risks and complications.
• Typically results in a quick return to normal activities after recovery.

Recovery

• Care Instructions: Keep the cast dry and clean. Follow up with regular check-ups.
• Recovery Time: Usually 6-8 weeks, depending on the fracture's severity.
• Restrictions: Avoid weight-bearing on the affected foot until cleared by the doctor.

Alternatives

• Surgical Treatment: Involves manipulating and fixing the bone, often with hardware.
  • Pros: May be necessary for severe fractures.
  • Cons: Higher risk, recovery time, and potential complications.
• Manipulation and Casting: If the bone position needs adjustment but surgery is not required.
  • Pros and Cons: Generally faster recovery but might involve anesthesia.

Patient Experience

• During Procedure: Minimal discomfort during the application of the cast.
• After Procedure: Mild pain and swelling can be expected but can be managed with pain relievers and rest. Patients should follow care instructions diligently to avoid complications.