Name of the Procedure:

Percutaneous Skeletal Fixation of Metatarsal Fracture, with Manipulation, each

• Commonly called "Metatarsal Pin Fixation" or "Pinning of Metatarsal Fracture"
• Medical term: Percutaneous skeletal fixation of metatarsal fracture

Summary

Percutaneous skeletal fixation of a metatarsal fracture involves stabilizing broken bones in the foot using pins or screws inserted through the skin. This is performed to realign and secure the bones, ensuring proper healing.

Purpose

To treat fractures of the metatarsal bones in the foot, which may be caused by trauma or injury. The goal is to realign the fractured bones to promote proper healing and restore normal function and mobility of the foot.

Indications

• Acute metatarsal fractures with displacement or misalignment
• Multiple fractures or complex fracture patterns
• Poor response to conservative treatments (e.g., casting or splinting)

Preparation

• Patient may need to fast for several hours prior to the procedure.
• Adjustments to current medications, particularly blood thinners, as directed by the healthcare provider.
• Pre-operative imaging, such as X-rays or CT scans, to assess the fracture details.

Procedure Description

1. Under local or general anesthesia, small incisions are made near the fracture site.
2. Specialized tools are used to manipulate the fracture and realign the bones.
3. Pins or screws are inserted percutaneously (through the skin) to stabilize the bones.
4. Incision sites are closed and dressed.

Tools:

• X-ray guidance (fluoroscopy)
• Pins or screws
• Surgical instruments for manipulation

Anesthesia: Local or general anesthesia as determined by patient and provider.

Duration

The procedure typically takes about 1 to 2 hours.

Setting

Performed in a hospital or outpatient surgical center.

Personnel

• Orthopedic surgeon or foot and ankle specialist
• Surgical nurse or assistant
• Anesthesiologist (if general anesthesia is used)

Risks and Complications

Common risks:

• Infection at the pin insertion site
• Bleeding
• Pain and swelling

Rare complications:

• Nerve or blood vessel damage
• Delayed bone healing or nonunion
• Hardware failure or migration

Benefits

• Improved alignment and stability of the fractured bones
• Quicker return to normal activities compared to conservative treatments
• Lower risk of long-term complications or deformity

Recovery

• Immobilization of the foot in a cast or boot for a few weeks
• Instructions for weight-bearing restrictions and use of crutches
• Follow-up appointments for X-rays and assessment
• Physical therapy to restore strength and mobility
• Expected complete recovery in 6-12 weeks

Alternatives

• Non-surgical treatments like casting, though these may not be suitable for displaced or complex fractures.
• Open surgical fixation, which may involve larger incisions and a longer recovery time.

Patient Experience

During the procedure:

• Minimal discomfort with local anesthesia, or unconsciousness with general anesthesia.
• A sensation of pressure or movement may be felt if under local anesthesia.

After the procedure:

• Pain and swelling managed with medications.
• Instructions for wound care and activity limitations.
• Gradual return to weight-bearing as healing progresses.