28490 Closed treatment of fracture great toe, phalanx or phalanges; without manipulation

Name of the Procedure:

Closed treatment of fracture great toe, phalanx or phalanges; without manipulation

Summary

This procedure involves the treatment of a broken bone in the big toe without the need to manually adjust or realign the fractured bones. It is a non-surgical approach that typically involves immobilization and monitoring to ensure proper healing.

Purpose

The procedure aims to support the healing of a fractured great toe while minimizing pain and preventing further injury. It helps restore normal function and mobility to the toe without the need for invasive surgery.

Indications

• Acute pain, swelling, or bruising in the big toe following an injury.
• Difficulty walking or bearing weight on the affected foot.
• Visible deformity or abnormal positioning of the big toe may not be present since realignment is not required.
• X-ray confirmation of a fracture in the phalanx or phalanges of the great toe.

Preparation

• Generally, no special preparation is required for this procedure.
• The patient may be advised to rest and avoid putting weight on the injured foot before treatment.
• Diagnostic imaging, like an X-ray, will be performed to confirm the fracture and its location.

Procedure Description

1. The patient will be seated or lying down comfortably.
2. The healthcare professional will examine the toe and review the X-ray images.
3. A splint, cast, or buddy taping (securing the fractured toe to an adjacent, unaffected toe) will be applied to immobilize the toe.
4. Instructions for at-home care, including potential use of ice packs and elevation, will be given.

Duration

The procedure typically takes about 15-30 minutes.

Setting

The procedure is performed in an outpatient setting, such as a hospital, clinic, or urgent care center.

Personnel

• Primary care physician or orthopedic specialist
• Medical assistant or nurse

Risks and Complications

• Minimal risks as it is a non-invasive procedure
• Possible complications include improper healing, persistent pain, or limited mobility
• Risk of developing complications if the fracture is more severe than initially diagnosed and requires further intervention

Benefits

• Non-invasive with minimal discomfort
• Quick procedure with immediate immobilization
• Supports natural healing of the bone

Recovery

• The patient will need to keep the toe immobilized and elevated as much as possible.
• Crutches may be used to avoid weight-bearing on the injured foot.
• Follow-up appointments will monitor healing progress.
• Typical recovery time ranges from 4 to 6 weeks, depending on the severity of the fracture.

Alternatives

• Open reduction and internal fixation (surgical approach) if the fracture is severe or displaced
• External fixation or casting with manipulation if the fracture requires realignment
• Pros: Closed treatment is less invasive and carries fewer risks.
• Cons: May not be suitable for all types of fractures.

Patient Experience

• The patient might feel discomfort during immobilization, but pain is generally managed with over-the-counter pain medications.
• Adjusting to limited mobility and care routines for the splint or cast may be necessary.
• Regular follow-ups are crucial to ensure proper healing and address any concerns.