28635 Closed treatment of metatarsophalangeal joint dislocation; requiring anesthesia

Name of the Procedure:

Closed Treatment of Metatarsophalangeal Joint Dislocation; Requiring Anesthesia

Summary

This procedure involves manually realigning a dislocated metatarsophalangeal (MTP) joint in the toe without making an incision. Anesthesia is used to ensure the patient feels no pain during the procedure.

Purpose

The procedure addresses dislocations in the joint where the toe meets the foot, which can be painful and limit mobility. The goal is to return the joint to its normal position to relieve pain and restore function.

Indications

• Severe pain in the toe joint
• Visible deformity or misalignment of the toe
• Difficulty moving the toe
• Swelling and bruising around the joint
• Patients who have not responded to non-surgical treatments

Preparation

• Follow fasting instructions as anesthesia may be used.
• Inform your doctor about any allergies or medications you are taking.
• Undergo necessary diagnostic tests like X-rays to confirm the dislocation.

Procedure Description

1. The patient is given anesthesia, usually local or regional, to numb the foot.
2. The medical team may use imaging techniques to locate the dislocation precisely.
3. The doctor carefully manipulates the toe to move the dislocated joint back into place, known as a closed reduction.
4. No surgical incision is made during this process.
5. Once realigned, the toe may be immobilized with a splint or tape to ensure it stays in place.

Duration

The procedure typically takes about 30 to 60 minutes.

Setting

The procedure is commonly performed in a hospital, outpatient clinic, or surgical center.

Personnel

• Orthopedic surgeon or emergency physician
• Nurses
• Anesthesiologist or nurse anesthetist

Risks and Complications

• Infection
• Nerve damage
• Re-dislocation
• Joint stiffness or reduced mobility
• Adverse reactions to anesthesia

Benefits

• Immediate pain relief
• Restoration of normal toe alignment and function
• Avoidance of more invasive surgery Benefits can usually be felt immediately after recovery from anesthesia.

Recovery

• Keep the foot elevated and apply ice to reduce swelling.
• Follow immobilization instructions from your doctor.
• Avoid putting weight on the affected foot for a specified period.
• Attend follow-up appointments to monitor healing.
• Full recovery typically takes a few weeks.

Alternatives

• Non-surgical treatments such as rest, ice, compression, and elevation (RICE).
• Surgical open reduction in severe cases or if closed reduction fails.
• Pros: Non-surgical options are less invasive. Cons: May not be effective for severe dislocations.

Patient Experience

• Patients might feel some discomfort or mild pain once the anesthesia wears off.
• Pain management will include prescribed pain relievers.
• Most patients return to normal activities within a few weeks, adhering to post-procedure care instructions.