28666 Percutaneous skeletal fixation of interphalangeal joint dislocation, with manipulation

Name of the Procedure:

Percutaneous Skeletal Fixation of Interphalangeal Joint Dislocation, with Manipulation

Summary

This procedure involves realigning a dislocated interphalangeal joint (a joint in the finger) and securing it using pins or wires inserted through the skin. The aim is to restore normal joint alignment and function.

Purpose

This procedure addresses dislocations of the interphalangeal joint, which involves the displacement of the bones within the finger joint. The goal is to reposition the joint correctly and stabilize it to facilitate proper healing and restore normal movement and function.

Indications

• Severe pain and visible deformity in the finger
• Loss of finger function or movement
• Swelling and bruising around the affected joint
• Failure of conservative treatments (e.g., splinting, manual realignment)

Preparation

• Fasting may be required if general anesthesia is planned.
• Adjustment or cessation of certain medications as advised by the doctor.
• Preoperative diagnostic tests such as X-rays to assess the extent of the dislocation and any associated fractures.

Procedure Description

1. The patient is positioned comfortably, and local or general anesthesia is administered.
2. The surgeon manipulates the dislocated joint to realign it manually.
3. Percutaneous pins or wires are inserted through the skin and into the bones to hold the joint in the correct position.
4. Proper alignment is confirmed via X-ray imaging.
5. The pins or wires are left in place until the joint heals, typically several weeks.

Duration

The entire procedure generally takes about 30 minutes to 1 hour.

Setting

The procedure is typically performed in an outpatient clinic, surgical center, or hospital setting.

Personnel

• Orthopedic surgeon or hand surgeon
• Surgical nurse or technician
• Anesthesiologist or nurse anesthetist (if general anesthesia is used)

Risks and Complications

• Infection at the pin sites
• Damage to surrounding nerves or blood vessels
• Joint stiffness or restricted motion
• Pain or discomfort at the fixation sites
• Nonunion or improper healing of the joint

Benefits

• Restores proper joint alignment and function
• Reduces pain and discomfort
• Prevents long-term deformity and arthritis
• Faster recovery compared to invasive surgical procedures

Recovery

• Keep the affected hand elevated initially to reduce swelling.
• Follow wound care instructions to prevent infection.
• Regular follow-up appointments to monitor healing and pin condition.
• Physical therapy may be recommended to regain strength and flexibility.
• Pins or wires are usually removed after 4-6 weeks.

Alternatives

• Closed reduction and splinting: non-surgical realignment and immobilization.
• Open surgical reduction: for complex cases or when percutaneous methods fail.
• Each alternative varies in invasiveness, recovery time, and effectiveness, depending on the specific case.

Patient Experience

• Patients may experience mild to moderate pain post-procedure, manageable with pain medications.
• Discomfort from the pins or wires may persist until they are removed.
• The finger will be immobilized, and full movement will be restricted until healing is complete.