23480 Osteotomy, clavicle, with or without internal fixation

Name of the Procedure:

Osteotomy, Clavicle, with or without Internal Fixation

Summary

An osteotomy of the clavicle involves cutting and realigning the collarbone to correct deformities or improve function. This procedure can include the use of hardware such as plates or screws to stabilize the bone.

Purpose

This procedure addresses issues such as clavicle fractures, non-unions, malunions, or congenital abnormalities. The goal is to restore proper alignment, improve shoulder function, and relieve pain.

Indications

• Severe clavicle fractures that do not heal properly
• Clavicle malunion (healing in an incorrect position)
• Congenital clavicle deformities
• Non-union where the bone fails to heal naturally
• Persistent pain or functional limitations due to clavicle issues

Preparation

• Fasting for 6-8 hours before the procedure if general anesthesia is planned.
• Discontinuing specific medications like blood thinners as advised by the doctor.
• Pre-surgery imaging such as X-rays or CT scans to plan the osteotomy.

Procedure Description

1. Anesthesia: General or regional anesthesia is administered.
2. Incision: A surgical incision is made over the clavicle.
3. Cutting and Realignment: The surgeon cuts the bone and repositions it.
4. Fixation (if needed): Internal fixation devices like plates or screws are used to stabilize the bone.
5. Closure: The incision is closed with sutures or staples.

Duration

The procedure typically takes about 1 to 2 hours.

Setting

Performed in a hospital or surgical center, usually requiring outpatient or short hospital stay.

Personnel

• Orthopedic surgeon
• Anesthesiologist
• Surgical nurse
• Radiologic technologist (if intraoperative imaging is needed)

Risks and Complications

• Infection
• Bleeding
• Anesthesia complications
• Damage to surrounding nerves or blood vessels
• Non-union or malunion of the bone
• Hardware irritation or failure

Benefits

• Relief from pain
• Improved shoulder function and range of motion
• Proper alignment of the clavicle
• Enhanced overall quality of life

Recovery

• Post-operative care includes pain management, wound care, and physical therapy.
• Typical recovery time ranges from 6 to 12 weeks, with restrictions on heavy lifting and physical activity.
• Follow-up appointments are necessary to monitor healing.

Alternatives

• Non-surgical management: physical therapy, bracing, and pain management.
• Closed reduction and internal fixation (without osteotomy) for certain fractures.
• Pros and cons depend on the specific condition, severity, and patient health.

Patient Experience

• Expect some pain and swelling after the procedure, managed with pain medications.
• Use of a sling may be required for a few weeks.
• Gradual return to normal activities with specific restrictions as recommended by the surgeon.
• Physical therapy often necessary to restore full function.