23195 Resection, humeral head

Name of the Procedure:

Resection, Humeral Head
Common names: Shoulder Resection, Partial Shoulder Arthroplasty

Summary

A resection of the humeral head is a surgical procedure to remove part of the upper arm's humeral head, typically damaged or diseased. This procedure is done to alleviate pain, improve shoulder function, and enhance the patient's quality of life.

Purpose

This procedure addresses issues like severe arthritis, fractures, tumors, or other conditions causing pain and impaired function in the shoulder. The goal is to relieve pain, restore range of motion, and improve arm strength.

Indications

• Severe osteoarthritis or rheumatoid arthritis not responsive to conservative treatments.
• Complex fractures of the humeral head.
• Tumors that involve the humeral head.
• Avascular necrosis where blood supply to the bone is compromised.
• Failed previous shoulder surgeries.

Preparation

• Fasting for at least 8 hours before the procedure.
• Stopping certain medications, such as blood thinners, as directed by your doctor.
• Undergoing pre-operative imaging tests like X-rays or MRI scans.
• Blood tests and a general pre-surgery physical examination.

Procedure Description

1. Anesthesia: General anesthesia is administered to ensure the patient is asleep and pain-free.
2. Incision: A surgical incision is made over the shoulder.
3. Resection: The surgeon removes the damaged portion of the humeral head.
4. Reconstruction: Depending on the condition, the surgeon may smooth the bone, reshape it, or prepare it for a prosthetic implant.
5. Closure: The incision is then closed with sutures or staples, and the area is bandaged.

Tools used: Surgical scalpel, retractors, bone saw, and sometimes prosthetic devices.

Duration

Typically, the procedure takes about 1 to 2 hours.

Setting

The procedure is usually performed in a hospital or surgical center.

Personnel

• Orthopedic Surgeon
• Surgical Nurse
• Anesthesiologist
• Surgical Technologist

Risks and Complications

Common risks:

• Infection
• Bleeding
• Blood clots

Rare risks:

• Nerve damage
• Joint stiffness
• Prosthesis complications

Management involves post-operative antibiotics, blood thinners, physical therapy, and in some cases, additional surgeries.

Benefits

• Significant reduction in shoulder pain.
• Improved shoulder function and range of motion.
• Enhanced quality of life and daily activities. Benefits are often realized within a few weeks to months post-surgery.

Recovery

• Post-operative pain management with prescribed medications.
• Wearing a sling for several weeks to immobilize the shoulder.
• Physical therapy to aid in recovery.
• Follow-up appointments to monitor healing. Full recovery can take several months.

Alternatives

• Medication and physical therapy for less severe cases.
• Shoulder arthroscopy for minor repairs.
• Total shoulder replacement if resection alone is not sufficient.
• Each alternative has different pros and cons, often weighing typically less invasiveness versus effectiveness.

Patient Experience

• The patient may experience pain and discomfort immediately following the procedure, managed by pain medications.
• Some swelling and bruising are expected around the incision site.
• Gradual return to normal activities with physical therapy support.
• Ongoing monitoring and adjustments in physical activity as recommended by the surgeon.