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Closed treatment of proximal tibiofibular joint dislocation; requiring anesthesia

CPT4 code

Name of the Procedure:

Closed Treatment of Proximal Tibiofibular Joint Dislocation (requiring anesthesia)

Summary

This procedure involves the realignment of the proximal tibiofibular joint, which is located near the knee. The realignment is performed without the need for an incision, and anesthesia is used to ensure the patient’s comfort during the process.

Purpose

The procedure addresses dislocations of the proximal tibiofibular joint, which can cause pain, instability, and loss of function in the leg. The goal is to restore proper alignment, relieve pain, and improve function.

Indications

  • Acute dislocation of the proximal tibiofibular joint
  • Severe pain and swelling around the knee
  • Instability or inability to bear weight on the affected leg
  • No responding to conservative treatments such as rest, ice, or compression

Preparation

  • Fasting for 6-8 hours before the procedure if general anesthesia is used.
  • Medication adjustments as instructed by the healthcare provider.
  • Pre-procedure diagnostic imaging such as X-rays or MRI to assess the dislocation.

Procedure Description

  1. The patient is positioned comfortably, and anesthesia is administered.
  2. The physician will apply gentle but firm pressure to manipulate the bones back into their proper position.
  3. The alignment is confirmed with imaging techniques.
  4. A splint or brace may be applied to maintain the joint's position during initial healing.

Duration

Typically, the procedure takes about 30 minutes to 1 hour, depending on the complexity of the dislocation.

Setting

The procedure is generally performed in a hospital or outpatient surgical center.

Personnel

The healthcare team usually includes:

  • Orthopedic surgeon
  • Anesthesiologist
  • Nursing staff

Risks and Complications

  • Pain or discomfort during and after the procedure
  • Risk of infection
  • Possible nerve or blood vessel injury
  • Recurrence of the dislocation
  • Stiffness or reduced range of motion

Benefits

  • Relief from pain and discomfort
  • Restored stability and function of the affected leg
  • Improved ability to bear weight and perform daily activities

Recovery

  • Post-procedure care includes rest, ice application, and elevation of the leg.
  • Pain management with prescribed medications.
  • Follow-up appointments to monitor healing.
  • Physical therapy may be recommended to restore strength and flexibility.
  • Complete recovery may take several weeks, with gradual resumption of activities as advised by the healthcare provider.

Alternatives

  • Conservative management with immobilization and physical therapy (less effective for severe dislocations).
  • Open surgical treatment (used for irreducible dislocations or associated injuries).
  • Pros of closed treatment: less invasive, quicker recovery. Cons: May not be effective for all cases.

Patient Experience

  • The patient will be asleep or sedated during the procedure, ensuring no pain is felt.
  • Post-procedure discomfort manageable with medications.
  • Temporary limitations on movement and activities.
  • Gradual improvement in symptoms and function over days to weeks.

Medical Policies and Guidelines for Closed treatment of proximal tibiofibular joint dislocation; requiring anesthesia

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