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Closed treatment of proximal fibula or shaft fracture; without manipulation

CPT4 code

Name of the Procedure:

Closed Treatment of Proximal Fibula or Shaft Fracture; Without Manipulation
Common name(s): Non-operative treatment for fibula fracture

Summary

In this procedure, a broken fibula (the smaller of the two bones in the lower leg) is treated without performing any manipulation or surgical intervention. Instead, the fracture is allowed to heal naturally, often with the aid of immobilization methods like a cast or brace.

Purpose

This procedure addresses fractures of the proximal fibula or the shaft of the fibula. The goals are to stabilize the fracture, control pain, and facilitate natural healing without surgical intervention.

Indications

  • Simple, non-displaced fractures of the proximal fibula or shaft
  • Patients who are good candidates for non-surgical treatment
  • Absence of complications that would necessitate surgical intervention

Preparation

  • No specific fasting or medication adjustments are usually needed.
  • Assessment through physical examination and imaging studies such as X-rays to determine fracture type and appropriateness of the treatment.

Procedure Description

  1. A thorough physical examination is conducted to assess the injury.
  2. Diagnostic imaging, typically X-rays, is reviewed to confirm the nature and extent of the fracture.
  3. The leg is immobilized using a cast, brace, or splint to ensure stabilization of the fracture site and prevent further injury.
  4. Periodic follow-up appointments are scheduled to monitor the healing process through additional X-rays.

Duration

The initial application of immobilization typically takes about 30 minutes to 1 hour. The overall healing process can take several weeks to a few months, depending on the patient's age, health, and the nature of the fracture.

Setting

Outpatient clinic, hospital, or orthopedic center.

Personnel

  • Orthopedic surgeon or an orthopedic physician
  • Nurses or medical assistants for support

Risks and Complications

  • Minimal risks since there is no surgical intervention.
  • Potential complications include improper healing, malunion (healing in an incorrect position), or delayed healing.
  • Rare risks include blood clots or deep vein thrombosis due to prolonged immobilization.

Benefits

  • Non-invasive with no surgical risks.
  • Reduced recovery time compared to surgical options.
  • Minimal disruption to daily life.

Recovery

  • Patients typically wear a cast, brace, or splint for several weeks.
  • Elevation of the leg and ice application may be advised to reduce swelling.
  • Gradual return to normal activities as instructed by the physician.
  • Follow-up visits to monitor healing progress and imaging studies as needed.

Alternatives

  • Surgical intervention with internal fixation methods if the fracture is complicated or displaced.
  • Functional bracing which allows for more movement than a traditional cast
  • Pros of non-surgical treatment include reduced risk and quicker recovery, but may not be suitable for all fracture types.

Patient Experience

  • Patients may experience discomfort or pain during the initial period of immobilization.
  • Pain management through prescribed medications.
  • Patients should follow physicians' advice on weight-bearing practices and physical activity to ensure proper healing.

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