Name of the Procedure:

Manipulation of ankle under general anesthesia (includes application of traction or other fixation apparatus)

Summary

This procedure involves the manual adjustment and alignment of the ankle joint while the patient is under general anesthesia. It may include the application of traction or other fixation devices to keep the joint stable. General anesthesia ensures that the patient feels no pain during the procedure.

Purpose

This procedure addresses conditions such as dislocated ankles, fractures, or severe sprains. The primary goal is to correctly realign the joint, reduce pain, restore function, and prevent long-term complications.

Indications

• Traumatic dislocation or fracture of the ankle
• Severe ankle sprains with significant misalignment
• Chronic ankle instability unresponsive to conservative treatment

Preparation

• Fasting for at least 6-8 hours before the procedure
• Possible cessation of certain medications, as directed by the physician
• Preoperative imaging tests, such as X-rays or MRI scans, to assess the extent of the injury

Procedure Description

1. The patient is given general anesthesia to ensure they are unconscious and free of pain.
2. The surgeon or orthopedic specialist manually manipulates the ankle to realign the bones and joint structures.
3. Traction or a fixation device may be applied to maintain proper alignment during healing.
4. Once the manipulation is complete, additional imaging may be taken to confirm proper alignment.
5. The area may be immobilized with a cast or splint to protect it during the initial recovery period.

Duration

The procedure typically takes about 30 minutes to an hour, depending on the complexity of the injury.

Setting

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

Personnel

• Orthopedic surgeon or specialist
• Anesthesiologist
• Surgical nurses
• Radiologic technologist, if imaging is required

Risks and Complications

• Infection
• Blood clots
• Adverse reactions to anesthesia
• Nerve or blood vessel damage
• Incomplete healing or improper alignment
• Need for further surgery

Benefits

• Relief from pain and discomfort
• Improved joint function and stability
• Prevention of long-term complications such as arthritis
• Enhanced ability to bear weight and move the ankle normally

Recovery

• Immediate post-procedure monitoring in the recovery room
• Pain management with prescribed medications
• Instructions on weight-bearing restrictions
• Physical therapy may be recommended to restore strength and mobility
• Follow-up appointments to monitor healing and remove any fixation devices

Alternatives

• Non-surgical reduction with sedation (for less severe cases)
• Physical therapy and rehabilitation without surgical intervention (if the condition allows)
• Use of braces or orthotics to stabilize the ankle

Patient Experience

Patients will be under general anesthesia, so they will not feel or remember the procedure. Post-procedure, they may experience pain and swelling, which can be managed with medication. Discomfort usually lessens within a few days, and physical therapy may be necessary to restore full function. Regular follow-up appointments will ensure proper healing.