28435 Closed treatment of talus fracture; with manipulation

Name of the Procedure:

Closed Treatment of Talus Fracture with Manipulation (also known as Non-Surgical Talus Fracture Reduction)

Summary

This procedure involves the realignment and stabilization of a broken talus bone in the ankle without the need for surgical incision. Manipulation is performed to set the bone properly.

Purpose

The procedure addresses fractures of the talus bone, typically due to significant trauma. The goal is to align the bone correctly to ensure proper healing, alleviate pain, restore function, and prevent long-term complications.

Indications

• Acute pain and swelling in the ankle after trauma.
• Visible or palpable misalignment of the ankle.
• X-ray or other imaging confirming a fracture of the talus.
• Patients who are unable to bear weight on the affected ankle.

Preparation

• Fasting may be required if sedation is used.
• Adjustment or discontinuation of certain medications (e.g., blood thinners) under medical advice.
• Pre-procedure imaging (X-ray, CT scans) to evaluate the extent of the fracture.

Procedure Description

1. The patient is positioned to allow easy access to the ankle.
2. Anesthesia or sedation is administered if needed to ensure patient comfort.
3. The physician manually manipulates the foot and ankle to align the fractured talus bone.
4. Imaging (e.g., X-ray) is used to confirm proper alignment.
5. A cast or splint is applied to immobilize the ankle and facilitate healing.
6. Follow-up imaging is often done to ensure the bone remains properly aligned as it heals.

Duration

The procedure typically takes about 30 minutes to 1 hour, depending on the complexity of the fracture and patient response.

Setting

The procedure is usually performed in a hospital emergency department, outpatient clinic, or surgical center.

Personnel

• Orthopedic surgeon or trained medical physician
• Nurses
• Radiology technicians (for imaging)
• Anesthesiologist (if sedation is required)

Risks and Complications

• Pain or discomfort during manipulation.
• Improper alignment necessitating further intervention.
• Compartment syndrome (rare but serious complication).
• Nonunion or malunion of the fracture.
• Nerve or blood vessel damage.
• Infection from immobilization devices.

Benefits

• Proper realignment helps the bone heal correctly and reduces future complications.
• Pain relief and restoration of ankle function.
• Avoiding surgical risks and potential complications associated with open surgery.

Recovery

• Keep the affected leg elevated and apply ice to reduce swelling.
• Use crutches to avoid weight-bearing on the affected foot.
• Follow-up appointments for X-rays and assessment.
• Physical therapy may be required to restore movement and strength.
• Full recovery can take several weeks to months, depending on the severity of the fracture.

Alternatives

• Open reduction and internal fixation (surgical option).
• Casting without manipulation, which may be less effective if the bone is significantly misaligned.

Patient Experience

• The patient may feel pressure or discomfort during the manipulation, but pain is managed with anesthesia or sedation.
• After the procedure, there may be some soreness and swelling.
• Pain management with prescribed medications helps ensure comfort during recovery.
• Regular follow-up is crucial to monitor healing progress and address any issues.