Closed treatment of calcaneal fracture; with manipulation
CPT4 code
Name of the Procedure:
Closed Treatment of Calcaneal Fracture with Manipulation
Common Names: Non-surgical treatment of heel bone fracture, Closed calcaneal fracture reduction
Summary
This procedure involves treating a fracture of the heel bone (calcaneus) without making any surgical incisions. Manipulation is performed to realign the broken bone pieces back to their normal position.
Purpose
Condition Addressed: Calcaneal (heel bone) fractures
Goals/Outcomes: To realign the fractured bone, restore foot functionality, and promote effective healing while minimizing pain.
Indications
Symptoms/Conditions: Severe heel pain, swelling, bruising, inability to bear weight on the affected foot, and noticeable deformity post-injury.
Patient Criteria: Suitable for patients with non-displaced or minimally displaced fractures, those with contraindications to surgery, or those preferring a non-surgical treatment.
Preparation
Pre-procedure Instructions:
- Avoid eating or drinking if sedation is planned.
- Stop certain medications as advised by the doctor.
- Wear loose, comfortable clothing to access the injured foot easily.
Diagnostic Tests/Assessments:
- X-rays or CT scans to determine the extent and location of the fracture.
- Medical history review and physical examination.
Procedure Description
- Initial Assessment: The healthcare provider reviews diagnostic images and assesses the injury.
- Anesthesia/Sedation: Local anesthesia or conscious sedation may be administered to minimize discomfort.
- Manipulation: The physician carefully manipulates the foot to realign the bone fragments.
Immobilization: Once aligned, the foot is immobilized using a cast, splint, or brace to maintain the position.
Tools/Equipment: X-ray machine, cast materials, splints, or braces.
Duration
Typically takes about 30 minutes to 1 hour.
Setting
Performed in a hospital emergency room, outpatient clinic, or orthopedic surgical center.
Personnel
Healthcare Professionals Involved: Orthopedic surgeon or specialist, nurses, radiology technician, anesthesiologist (if sedation is used).
Risks and Complications
Common Risks: Pain, swelling, bruising, and discomfort during manipulation.
Rare Risks: Improper bone alignment necessitating surgical intervention, nerve or blood vessel damage, and delayed healing.
Benefits
Expected Benefits: Effective realignment of the fracture, reduced pain, and restored foot function.
Timeline: Immediate alleviation of severe symptoms, with gradual healing over weeks to months.
Recovery
Post-procedure Care:
- Elevate the foot and apply ice to reduce swelling.
- Keep the immobilization device dry and clean.
- Follow weight-bearing restrictions as instructed.
- Attend follow-up appointments for X-rays and progress checks.
Expected Recovery Time: 6 to 12 weeks, depending on the fracture severity.
Restrictions: Limited weight-bearing activities; avoid strenuous activities until cleared by the doctor.
Alternatives
Other Treatment Options:
- Surgical Treatment: Open reduction and internal fixation (ORIF) for severe cases.
- Pros: Potentially better alignment and quicker recovery for complex fractures.
- Cons: Increased surgical risk, longer initial recovery, and potential for complications.
Patient Experience
During the Procedure: Patients may feel pressure and brief discomfort during manipulation. Sedation will minimize pain and anxiety.
After the Procedure: Pain and swelling can be managed with medications and rest. Comfort measures include elevation and ice application.