28415 Open treatment of calcaneal fracture, includes internal fixation, when performed

Name of the Procedure:

Open treatment of calcaneal fracture, includes internal fixation, when performed

Summary

In this procedure, a surgeon makes an incision to access the broken heel bone (calcaneus) and realigns the fractures. Metal plates, screws, or pins are then used to internally fixate, or stabilize, the bones to ensure they heal properly.

Purpose

This procedure addresses fractures of the heel bone (calcaneus), which are often caused by traumatic injuries such as falls. The goal is to realign and stabilize the fractured bone to restore normal foot function and alleviate pain.

Indications

• Traumatic heel bone fractures
• Displacement or misalignment of bone fragments
• Severe pain and swelling in the heel
• Reduced mobility and ability to bear weight on the affected foot

Preparation

• Patients are usually instructed to fast 6-8 hours before the procedure.
• Adjustments to current medications may be necessary, especially blood thinners.
• Preoperative imaging tests, such as X-rays or CT scans, are conducted to assess the fracture.

Procedure Description

1. The patient is administered general anesthesia.
2. An incision is made in the skin near the heel to access the fractured bone.
3. Bone fragments are realigned into their correct anatomical position.
4. Internal fixation devices (metal plates, screws, or pins) are used to stabilize the bone.
5. The incision is closed with sutures or staples, and a sterile dressing is applied.

Duration

The procedure typically takes 2-3 hours, depending on the complexity of the fracture.

Setting

Usually performed in the operating room of a hospital or a specialized surgical center.

Personnel

• Orthopedic surgeon
• Surgical nurses
• Anesthesiologist
• Radiologic technologist (if intraoperative imaging is needed)

Risks and Complications

• Infection
• Bleeding
• Nerve damage
• Blood clots
• Delayed bone healing or non-union
• Chronic pain or mobility issues

Benefits

• Restoration of normal foot function
• Pain relief
• Improved ability to bear weight and walk
• Prevention of long-term complications like arthritis

Recovery

• Post-procedure care includes keeping the foot elevated and protected.
• Weight-bearing on the affected foot is typically restricted for several weeks.
• Physical therapy may be required to restore strength and mobility.
• Follow-up appointments are essential to monitor healing progress.

Alternatives

• Non-surgical treatment with casting or splinting (may not be effective for severe fractures).
• External fixation (less commonly used but can be an option).
• Pros and cons: Non-surgical methods can avoid the risks of surgery but may not provide as stable a repair, leading potentially to longer recovery times or improper healing.

Patient Experience

• During the procedure, patients will be under general anesthesia and not feel pain.
• Post-operatively, pain management includes medications and keeping the foot elevated.
• Physical discomfort and swelling are common but will gradually subside as healing progresses.