27842 Closed treatment of ankle dislocation; requiring anesthesia, with or without percutaneous skeletal fixation

Name of the Procedure:

Closed Treatment of Ankle Dislocation; Requiring Anesthesia, with or without Percutaneous Skeletal Fixation.

• Common name: Closed Ankle Reduction
• Medical term: Closed Manipulation of Ankle Dislocation

Summary

A closed ankle reduction is a medical procedure to reposition a dislocated ankle back into its proper place without making any incisions. This procedure may involve the use of anesthesia to manage pain, and sometimes percutaneous (through the skin) skeletal fixation to keep the ankle stable.

Purpose

The purpose of this procedure is to address ankle dislocations, which occur when the bones in the ankle joint are forced out of their normal alignment. The goals are to alleviate pain, restore proper alignment, and improve function and mobility of the ankle joint.

Indications

• Severe pain and swelling in the ankle.
• Visible deformity or misalignment of the ankle joint.
• Loss of function or inability to bear weight on the affected ankle.
• X-rays confirming the dislocation.

Preparation

• Fasting for at least 6-8 hours prior to the procedure if anesthesia is used.
• Stopping certain medications as advised by a healthcare provider.
• Pre-procedure assessments, including physical examination and imaging tests like X-rays or MRI to evaluate the extent of the dislocation.

Procedure Description

1. The patient is given anesthesia to ensure comfort during the procedure.
2. The healthcare provider manipulates the ankle externally to guide the dislocated bones back into their proper alignment.
3. If necessary, percutaneous skeletal fixation (using pins or screws through the skin) is applied to hold the bones in place.
4. The ankle is then immobilized with a splint or cast to maintain stability and promote healing.

Tools and Equipment

• Anesthesia equipment
• X-ray machine for imaging guidance
• Potential use of pins or screws for fixation

Anesthesia Details

• Local or general anesthesia, depending on the severity of the dislocation and patient factors.

Duration

Approximately 30 minutes to 1 hour.

Setting

The procedure is typically performed in a hospital or surgical center.

Personnel

• Orthopedic surgeon or emergency physician
• Anesthesiologist or nurse anesthetist
• Nurses or surgical technologists

Risks and Complications

• Common risks: Pain, swelling, bruising
• Rare risks: Infection, nerve or blood vessel damage, improper alignment, non-healing of the bones, necessity for additional surgery

Benefits

• Immediate relief from pain and correction of the dislocation.
• Restoration of normal anatomy and function.
• Improved mobility and reduced risk of long-term complications.

Recovery

• Post-procedure care includes keeping the ankle elevated, applying ice, and taking prescribed pain medications.
• Follow-up appointments for monitoring healing progress and X-rays to ensure proper alignment.
• Recovery typically ranges from a few weeks to several months, depending on the severity and any additional injuries.

Alternatives

• Open surgical reduction, which involves making an incision to reposition the bones.
• Conservative treatments such as physical therapy, although less commonly recommended for acute dislocations.
• Each alternative has its own risks and benefits, with closed reduction generally preferred for quicker recovery and less invasive nature.

Patient Experience

During the procedure, the patient will not feel any pain due to the anesthesia. After the procedure, they may experience discomfort and swelling, which can be managed with pain medications and proper post-care instructions. The immobilization device may cause some inconvenience, but it is crucial for proper healing. Regular follow-ups help ensure a smooth recovery process.