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Closed treatment of clavicular fracture; without manipulation

CPT4 code

Name of the Procedure:

Closed treatment of clavicular fracture; without manipulation

Common name(s): Non-surgical treatment of broken collarbone, Conservative management of clavicle fracture

Summary

This procedure involves treating a fractured collarbone without the need for surgery or physical manipulation. Typically, it focuses on allowing the bone to heal naturally through immobilization and supportive care.

Purpose

The procedure addresses clavicle fractures that don’t require surgical intervention. The primary goal is to provide stability and promote natural bone healing while minimizing pain and discomfort.

Indications

  • Acute clavicle fractures identified through imaging
  • Mild to moderate fractures that are well-aligned
  • Patients who do not have multiple or complex fractures requiring surgery
  • Those with minimal displacement of fracture segments

Preparation

  • No specific fasting or medication adjustments are typically required.
  • An X-ray or other imaging tests are performed to assess the fracture's location and severity.

Procedure Description

  1. The healthcare provider will assess the fracture through physical examination and imaging.
  2. A shoulder sling or figure-of-eight brace is applied to immobilize the arm and shoulder.
  3. Instructions are given for managing pain with over-the-counter pain medication.
  4. The patient may receive guidance on gentle exercises to prevent stiffness.

Duration

The application of the sling or brace takes approximately 10-15 minutes.

Setting

The procedure is performed in an outpatient clinic or the emergency department.

Personnel

  • Orthopedic surgeon or primary care physician
  • Nurses or medical assistants

Risks and Complications

  • Potential discomfort from immobilization devices
  • Risk of nonunion or delayed union (incomplete healing of the fracture)
  • Muscle stiffness or weakness from prolonged immobilization
  • Very rare risk of nerve or vascular injury

Benefits

  • Non-invasive and avoids surgical risks
  • Promotes natural healing of the bone
  • Allows the patient to recover with minimal disruption to daily life

Recovery

  • Continuous use of the sling or brace for several weeks, as directed by the physician
  • Gradual return to normal activities as healing progresses
  • Follow-up appointments to monitor healing, usually through imaging
  • Physical therapy may be recommended to restore strength and mobility

Alternatives

  • Surgical repair in cases of severe displacement or complex fractures
    • Pros: Direct stabilization and alignment of the bone, potentially faster recovery
    • Cons: Surgical risks, longer initial recovery period

Patient Experience

  • Initial period of discomfort and restricted arm movement
  • Pain can be managed with medication and supportive care
  • Generally, a positive outcome with proper adherence to recovery guidelines

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