Closed treatment of acromioclavicular dislocation; with manipulation
CPT4 code
Name of the Procedure:
Closed Treatment of Acromioclavicular (AC) Dislocation; with Manipulation
Summary
In layman's terms, this procedure involves manually realigning a dislocated acromioclavicular joint (where the collarbone meets the shoulder blade) without the need for surgical incision. This is done to restore proper joint function and alleviate pain.
Purpose
This procedure addresses acromioclavicular joint dislocation, a condition where the collarbone separates from the shoulder blade, often due to trauma. The goal is to restore normal alignment to relieve pain, improve shoulder function, and prevent long-term complications.
Indications
- Pain and swelling in the shoulder region following a fall or direct impact.
- Visible deformity where the collarbone meets the shoulder.
- Limited range of motion and weakness in the shoulder.
- Imaging studies confirming AC joint dislocation.
Preparation
- Patients may be advised to fast for a few hours before the procedure if sedation is planned.
- Discontinue certain medications, such as blood thinners, as directed by a healthcare provider.
- Diagnostic imaging (X-rays, MRI) to assess the dislocation severity.
- An overall health assessment and history review.
Procedure Description
- Anesthesia/Sedation: Local or general anesthesia may be administered to numb the area or relax the patient.
- Positioning: The patient is positioned comfortably, typically lying down.
- Manipulation: The healthcare provider manually maneuvers the collarbone and shoulder blade to realign the AC joint.
- Stabilization: The joint is then immobilized using a sling or brace to maintain alignment during the healing process.
Duration
The manipulation procedure itself typically takes about 15-30 minutes, though the total appointment time may be longer due to preparation and post-procedure care.
Setting
This procedure is usually performed in an emergency room, outpatient clinic, or hospital setting.
Personnel
- Orthopedic surgeon or emergency physician
- Nurses or medical assistants
- Anesthesiologist (if sedation is needed)
Risks and Complications
- Common risks: Pain, swelling, bruising, and temporary decreased range of motion.
- Rare risks: Joint instability, re-dislocation, nerve damage, and infection.
Benefits
- Pain relief and improved shoulder function.
- Quick realignment reduces the risk of long-term complications.
- Less invasive than surgical options, with a shorter recovery period.
Recovery
- Post-Procedure Care: Wear a sling or brace as directed, and follow specific care instructions for reducing swelling and pain.
- Expected Recovery Time: Usually 4-6 weeks for initial recovery. Physical therapy may be recommended to restore full shoulder function.
- Restrictions: Avoid lifting heavy objects and strenuous activities during the recovery period.
- Follow-Up: Regular follow-up appointments to monitor healing progress.
Alternatives
- Non-Surgical: Rest, ice, pain medications, and physical therapy.
- Surgical: Open reduction and internal fixation for severe or complicated dislocations.
- Pros and Cons: Non-surgical options may have a longer recovery time with potential for incomplete healing. Surgical options have a higher success rate but come with greater risks and longer downtime.
Patient Experience
- During the Procedure: Patients under local anesthesia may feel pressure and movement; those under general anesthesia will be asleep.
- After the Procedure: Expect tenderness and mild pain at the site; pain management will involve prescribed medications.
- Comfort Measures: Ice packs and pain medications will help manage discomfort. Physical therapy may be prescribed to aid recovery.
Always consult with your healthcare provider for personalized instructions and to ensure this procedure is right for you.