Name of the Procedure:

Treatment of Tarsal Bone Fracture (except talus and calcaneus); with Manipulation, each

Summary

This procedure involves the manual realignment of fractured tarsal bones in the foot (excluding the talus and calcaneus bones) to ensure proper healing. It is typically done without surgical intervention and is often followed by immobilization using a cast or splint.

Purpose

This procedure aims to treat fractures in the tarsal bones, promoting correct alignment and healing to restore the normal function and structure of the foot while minimizing complications such as malunion or chronic pain.

Indications

• Severe pain and swelling in the foot.
• Visible deformity or misalignment of the foot.
• Inability to bear weight or walk.
• Confirmed tarsal bone fractures via X-ray or other imaging studies (excluding the talus and calcaneus).

Preparation

• Fasting is generally not required unless sedation is planned.
• Patients may need to adjust medications, particularly blood thinners.
• Diagnostic imaging like X-rays or CT scans to assess the fracture extent.

Procedure Description

1. The patient is positioned to access the affected foot comfortably.
2. Local anesthesia or sedation might be administered to minimize pain.
3. The clinician manually manipulates the bones into proper alignment.
4. The foot is then immobilized with a cast or splint to maintain alignment during healing.
5. Post-manipulation X-rays are taken to confirm the bones are correctly aligned.

Duration

Typically, the procedure takes about 30 minutes to 1 hour.

Setting

This procedure is performed in a hospital, outpatient clinic, or surgical center.

Personnel

• Orthopedic surgeon or specialist.
• Nurses or physician assistants.
• Anesthesiologist, if sedation is used.

Risks and Complications

• Infection.
• Bleeding or bruising.
• Pain during or after the procedure.
• Improper bone healing or malunion.
• Nerve damage.
• Compartment syndrome (rare but serious).

Benefits

• Proper alignment of the fractured bones.
• Reduced pain and improved function.
• Prevention of long-term complications like chronic pain or deformity.
• Faster recovery compared to surgical interventions.

Recovery

• Keep the cast or splint dry and clean.
• Follow weight-bearing instructions from the healthcare provider.
• Pain management with prescribed medications.
• Follow-up appointments for X-rays and assessment.
• Full recovery may take several weeks to months, depending on the fracture severity.

Alternatives

• Non-manipulative treatment (rest, ice, elevation, and immobilization).
• Surgical intervention for severe or complex fractures.
• Pros and cons depend on the fracture type and patient health, with surgery carrying higher risks but sometimes offering more durable outcomes.

Patient Experience

• Mild discomfort or pain during manipulation, managed with local anesthesia or sedation.
• Possible soreness or stiffness post-procedure.
• Pain relief through prescribed painkillers.
• Temporary mobility limitations during recovery, often requiring the use of crutches or a walker.