28576 Percutaneous skeletal fixation of talotarsal joint dislocation, with manipulation

Name of the Procedure:

Percutaneous Skeletal Fixation of Talotarsal Joint Dislocation, with Manipulation

Summary

This procedure involves the realignment and stabilization of a dislocated joint between the talus and tarsal bones in the foot using minimally invasive techniques. It includes manipulating the bones back into place and then using screws or wires to hold them in position.

Purpose

This procedure addresses a dislocated talotarsal joint, which can cause significant pain, instability, and impaired foot function. The goal is to realign the bones properly to restore normal joint function and alleviate discomfort.

Indications

• Acute dislocation of the talotarsal joint
• Persistent instability or pain despite non-surgical treatment
• Decreased ability to walk or bear weight on the affected foot

Preparation

• Fasting for a specified period before the procedure
• Adjusting or discontinuing certain medications as directed by the physician
• Pre-procedural imaging tests like X-rays or CT scans to assess the dislocation

Procedure Description

1. Anesthesia: Administering regional or general anesthesia to ensure the patient is pain-free.
2. Incision: Making a small skin incision over the affected area.
3. Manipulation: Manually realigning the dislocated joint bones.
4. Fixation: Inserting percutaneous screws or wires to stabilize the bones.
5. Closure: Suturing the incision and applying a sterile dressing.

Duration

Typically, the procedure takes about 1-2 hours.

Setting

Performed in a hospital or surgical center equipped with necessary imaging and surgical tools.

Personnel

• Orthopedic surgeon
• Anesthesiologist
• Surgical nurses
• Radiology technician (if imaging is required during the procedure)

Risks and Complications

• Infection at the incision site
• Bleeding or hematoma formation
• Nerve or blood vessel injury
• Improper bone healing or misalignment
• Need for additional surgeries if initial fixation fails

Benefits

• Effective realignment of the dislocated joint
• Alleviation of pain and instability
• Improved foot function and ability to bear weight
• Quick recovery due to the minimally invasive nature of the procedure

Recovery

• Post-procedure pain management with prescribed medications
• Keeping the foot elevated and immobilized initially
• Gradual weight-bearing as recommended by the surgeon
• Physical therapy to restore strength and mobility
• Follow-up appointments for monitoring healing progress

Alternatives

• Closed reduction without fixation, though it carries a higher risk of recurrence
• Open surgical fixation for more severe dislocations
• Conservative management with splints or braces, but limited to minor dislocations and not always effective

Patient Experience

• During the procedure: The patient will be under anesthesia and should not feel any pain.
• After the procedure: Some discomfort and pain in the operated area, managed with medications. Swelling and the need to keep the foot immobilized. Gradual return to normal activities with guidance from the healthcare team.