Question

In the Musculoskeletal System subsection of the Surgery section in your CPT book, it discusses the following types of treatment: closed treatment, open treatment, and percutaneous skeletal fixation. What do each of these terms means? What are the differences between each of these types of treatment? Choose one of the types of treatment and give an example of a procedure that would be performed using that method, along with the code that would be assigned for the example.

Answer 1

Closed treatment specifically means that the fracture is not surgically opened (exposed to the external environment and directly visualized).Closed reduction is a procedure to set (reduce) a broken bone without cutting the skin open. The broken bone is put back in place, which allows it to grow back together. It works best when it is done as soon as possible after the bone breaks.

Open reduction and internal fixation (ORIF) is a type of surgery used to stabilize and heal a broken bone.

Open reduction internal fixation (ORIF) is a surgery to fix severely broken bones.

It’s only used for serious fractures that can’t be treated with a cast or splint. These injuries are usually fractures that are displaced, unstable, or those that involve the joint.

“Open reduction” means a surgeon makes an incision to re-align the bone. “Internal fixation” means the bones are held together with hardware like metal pins, plates, rods, or screws. After the bone heals, this hardware isn’t removed.

Percutaneous skeletal fixation is the surgical procedure of treating fractures by inserting surgical implants through the skin. It is applicable in the treatment of fractures in the pelvis and other bones in the body, including the spine. It is also known as percutaneous pinning.