Name of the Procedure:

Open treatment of proximal fibula or shaft fracture (includes internal fixation)

Summary

This procedure involves surgically exposing and correcting a broken bone in the upper part of the fibula or its shaft. The surgery includes the use of metal hardware, such as plates and screws, to stabilize the bone and ensure proper healing.

Purpose

The procedure addresses fractures of the fibula, a bone in the lower leg. The primary goal is to realign and stabilize the bone fragments to promote healing, restore limb function, and minimize complications such as improper bone healing or deformity.

Indications

• Acute pain and swelling in the lower leg following trauma.
• Visible or palpable deformity in the lower leg.
• Inability to bear weight on the affected leg.
• X-ray or other imaging confirming a fracture of the proximal fibula or its shaft.

Preparation

• Patients are typically instructed to fast for at least 8 hours before surgery.
• Medication adjustments, including possibly stopping blood thinners.
• Diagnostic tests such as X-rays, CT scans, or MRIs to evaluate the fracture.
• Preoperative blood tests and physical examination.

Procedure Description

1. Anesthesia is administered (general or regional).
2. The surgeon makes an incision over the fracture site to expose the bone.
3. The bone fragments are realigned (reduced).
4. Metal hardware (plates and screws) is placed and secured to stabilize the bone.
5. The incision is closed with sutures or staples.
6. A sterile bandage or dressing is applied.

Duration

The procedure typically takes 1 to 2 hours, depending on the complexity of the fracture.

Setting

The procedure is performed in a hospital operating room or a specialized surgical center.

Personnel

• Orthopedic surgeon
• Anesthesiologist
• Surgical nurses
• Operating room technician

Risks and Complications

• Infection at the surgical site.
• Blood clots.
• Nerve or blood vessel damage.
• Pain or discomfort at the hardware site.
• Allergic reaction to anesthesia.
• Delay in bone healing or non-union.

Benefits

• Realignment and stabilization of the fractured bone.
• Reduced pain and improved function of the affected leg.
• Typically, benefits are realized within 6 to 12 weeks as the bone heals.

Recovery

• Postoperative monitoring and pain management.
• Instructions on wound care and activity limitations.
• Physical therapy may be recommended to restore movement and strength.
• Follow-up appointments for X-rays to monitor bone healing.
• Recovery time varies but typically ranges from 6 to 12 weeks, with possible restrictions on weight-bearing activities.

Alternatives

• Non-surgical management with casting or splinting (less stable, may result in longer healing time).
• External fixation (application of a stabilizing frame outside the body).
• Each option has its own risks and benefits which should be discussed with the healthcare provider.

Patient Experience

• Patients may experience pain and swelling postoperatively, which can be managed with medications.
• Some initial discomfort from the hardware, which usually subsides as healing progresses.
• Physical therapy and gradual return to normal activities help in recovery and improving limb function.