28600 Closed treatment of tarsometatarsal joint dislocation; without anesthesia

Name of the Procedure:

Closed Treatment of Tarsometatarsal Joint Dislocation

Summary

This procedure involves realigning a dislocated joint in the foot without making any surgical incisions and without using anesthesia.

Purpose

The procedure addresses the dislocation of the tarsometatarsal joint, which connects the midfoot to the base of the toes. The goal is to restore normal joint alignment and function, alleviate pain, and prevent complications such as arthritis or long-term instability.

Indications

• Severe pain and swelling in the midfoot area.
• Visible deformity of the foot.
• Difficulty or inability to bear weight on the affected foot.
• Diagnosed dislocation of the tarsometatarsal joint on imaging studies.

Preparation

• Notify your physician of any medications or supplements you take.
• Follow any specific instructions provided by your healthcare provider, such as avoiding certain activities before the procedure.
• Imaging studies like X-rays may be conducted to confirm the dislocation.

Procedure Description

1. The patient is positioned comfortably, usually lying down.
2. The healthcare provider manually manipulates the dislocated joint to maneuver it back into proper alignment.
3. An X-ray may be taken to ensure the joint is correctly repositioned.
4. A cast, splint, or brace may be applied to immobilize the foot and maintain alignment.

Duration

The procedure typically takes about 15-30 minutes.

Setting

The procedure is usually performed in an outpatient clinic or an emergency room setting.

Personnel

• Orthopedic surgeon or foot specialist.
• Nurse or medical assistant.

Risks and Complications

• Pain or discomfort during the procedure.
• Potential for the joint to become dislocated again.
• Swelling and bruising.
• Rarely, damage to surrounding ligaments, nerves, or blood vessels.

Benefits

• Immediate pain relief from the realignment.
• Restoration of normal foot structure and function.
• Prevention of long-term complications such as arthritis.

Recovery

• Rest the foot and avoid putting weight on it for several weeks.
• Follow-up appointments for X-rays to ensure the joint remains in position.
• Gradual return to normal activities as advised by the healthcare provider.
• Physical therapy may be recommended to restore strength and flexibility.

Alternatives

• Open reduction and internal fixation surgery if closed treatment fails or is not feasible.
• Benefits of closed treatment include less invasiveness and faster initial recovery.
• Risks of surgical alternatives include higher complication rates and longer recovery.

Patient Experience

• The patient may feel some discomfort during the manipulation, but the procedure is generally quick.
• Post-procedure pain can be managed with over-the-counter pain relief medications.
• Instructions will be given for managing swelling and elevating the foot to promote healing.