28570 Closed treatment of talotarsal joint dislocation; without anesthesia

Name of the Procedure:

Closed Treatment of Talotarsal Joint Dislocation; Without Anesthesia

• Other Names: Non-Surgical Reduction of Talotarsal Joint Dislocation, Closed Reduction of Talotarsal Joint

Summary

Closed treatment of a talotarsal joint dislocation is a non-surgical procedure where a healthcare provider manually repositions dislocated bones in the talotarsal joint of the foot back to their normal alignment. This is done without the use of anesthesia.

Purpose

• Medical Condition: Dislocation of the talotarsal joint (where the talus bone in the ankle meets the tarsal bones of the foot).
• Goals: To restore normal alignment of the bones, alleviate pain, and prevent further injury or complications.

Indications

• Symptoms: Severe ankle pain, swelling, inability to bear weight, visibly deformed ankle or foot.
• Patient Criteria: Appropriate for patients with a diagnosed talotarsal joint dislocation who can tolerate the procedure without anesthesia.

Preparation

• Instructions: Usually minimal; may need someone to drive you home after the procedure.
• Diagnostics: X-rays or other imaging studies to confirm the dislocation and to plan the reduction.

Procedure Description

1. The patient is positioned comfortably with clear access to the affected ankle.
2. The healthcare provider will manually grasp the foot and perform specific maneuvers to realign the dislocated bones.
3. The correct alignment is confirmed via palpation and possibly additional imaging.

Duration

Typically, the actual manipulation takes just a few minutes, but the entire process (including preparation and post-reduction assessment) may take about 30 minutes.

Setting

Usually performed in an emergency room, outpatient clinic, or a hospital setting.

Personnel

Primarily performed by an orthopedic surgeon, emergency physician, or trained healthcare provider. A nurse or medical assistant may assist.

Risks and Complications

• Common Risks: Pain during the procedure, swelling, bruising.
• Rare Complications: Nerve or blood vessel injury, incomplete reduction, the need for surgical intervention if closed treatment fails.

Benefits

• Immediate Realignment: Rapid pain relief and restoration of normal foot function.
• Avoids Surgery: Non-invasive with fewer complications compared to surgical alternatives.

Recovery

• Post-Procedure Care: Rest, ice, compression, and elevation (RICE) to manage swelling and pain.
• Recovery Time: Depends on severity; typically a few weeks with possible physiotherapy.
• Follow-Up: Usually includes a follow-up appointment for assessment and possibly repeat imaging.

Alternatives

• Surgical Reduction: More invasive, involves anesthesia, and higher risk but necessary if closed treatment fails.
• Immobilization: Casting or splinting without reduction, not ideal if bones remain misaligned.

Patient Experience

• During Procedure: Likely to experience discomfort or pain as the joint is manipulated.
• After Procedure: Initial pain relief but possible soreness, swelling, and bruising.
• Pain Management: Over-the-counter pain medications, ice, and rest.