Name of the Procedure:

Open Treatment of Metatarsal Fracture (includes internal fixation, when performed, each)

Summary

Open treatment of a metatarsal fracture involves surgically realigning and stabilizing broken bones in the foot using screws, plates, or rods. This procedure helps ensure proper healing and restores the foot's structural integrity.

Purpose

This surgery treats broken metatarsal bones, which are crucial for foot balance and mobility. The primary goal is to realign the bones for proper healing, alleviate pain, and restore normal function as much as possible.

Indications

• Severe metatarsal fractures where the bones are misaligned.
• Fractures that fail to heal with conservative treatment.
• Open fractures where the bone breaks through the skin.
• Multiple fractures or complex breaks.
• Patients experiencing significant pain, swelling, or deformity.

Preparation

• Fasting as directed before surgery.
• Adjustments to current medications as advised by the doctor.
• Pre-operative imaging studies like X-rays or CT scans for surgical planning.
• Health assessments to ensure fitness for surgery, including blood tests and physical exams.

Procedure Description

1. Anesthesia Administration: General or regional anesthesia is administered.
2. Incision: A surgical incision is made over the fractured bone.
3. Realignment: Fractured bones are realigned to their correct anatomical positions.
4. Fixation: Screws, plates, or rods are implanted to stabilize the bones.
5. Closure: Incision is closed with stitches or surgical staples.
6. Dressing: The foot is dressed, and a cast or splint may be applied.

Duration

The procedure typically takes 1-2 hours.

Setting

Hospital operating room or outpatient surgical center.

Personnel

• Orthopedic surgeon
• Anesthesiologist
• Surgical nurse(s)
• Radiologic technologist (if intraoperative imaging is required)

Risks and Complications

• Infection at the surgical site
• Blood clots
• Nerve or blood vessel damage
• Delayed bone healing or non-union
• Hardware irritation or failure
• Anesthetic complications

Benefits

• Proper bone healing and alignment
• Pain relief
• Improved foot function and mobility
• Reduced risk of long-term complications from improper fracture healing

Recovery

• Post-surgical foot elevation and rest.
• Pain management with prescribed medications.
• Gradual weight-bearing activities as advised.
• Physical therapy to regain strength and mobility.
• Expected recovery time ranges from several weeks to several months, with follow-up appointments to monitor healing.

Alternatives

• Non-surgical treatments like casting or splinting (for less severe fractures).
• External fixation devices in some cases.
• Pros of alternatives include avoiding surgery; cons include potential misalignment and improper healing.

Patient Experience

During the procedure, patients are under anesthesia and won't feel pain. Post-surgery, there may be pain and swelling managed with medications. Elevation and rest are crucial, and patients may need crutches or a walker initially. Pain and discomfort typically reduce over the first few weeks.