23600 Closed treatment of proximal humeral (surgical or anatomical neck) fracture; without manipulation

Name of the Procedure:

Closed Treatment of Proximal Humeral (Surgical or Anatomical Neck) Fracture; Without Manipulation

Summary

This procedure involves treating a fracture of the upper arm bone (humerus) near the shoulder without the need to manually move the bone back into place.

Purpose

The procedure addresses fractures of the upper arm bone near the shoulder, typically due to injury or trauma. The goal is to allow the bone to heal properly without manual adjustment, alleviating pain and restoring function.

Indications

This procedure is appropriate for patients with:

• A small, non-displaced fracture of the proximal humerus
• Minimal swelling and pain that can be managed with conservative measures
• Good bone alignment that does not require surgical intervention

Preparation

• Follow doctor's instructions regarding medication adjustments.
• Usually, no fasting or special preparation is needed.
• Pre-procedure X-rays to assess the fracture.

Procedure Description

1. The patient is seated or lying down comfortably.
2. A sling or shoulder immobilizer is fitted to keep the arm in place.
3. Pain management is provided through oral medications or localized pain relief if needed.
4. Regular follow-up X-rays are scheduled to monitor healing.

Duration

The procedure itself takes about 15-30 minutes for fitting the immobilizer and pain management setup.

Setting

This procedure is typically performed in an outpatient clinic or a hospital emergency department.

Personnel

• Orthopedic surgeon or emergency room physician
• Nurse or medical assistant

Risks and Complications

• Pain or discomfort
• Swelling
• Potential for the fracture to shift, requiring further intervention
• Delayed healing or nonunion

Benefits

• Non-invasive treatment option
• Lower risk of complications compared to surgical interventions
• Allows the bone to heal naturally with immobilization

Recovery

• Use of a sling or shoulder immobilizer for several weeks.
• Follow-up appointments for X-rays to monitor healing.
• Gradual return to normal activities as directed by your doctor.
• Physical therapy may be recommended to restore strength and mobility.

Alternatives

• Surgical intervention if the fracture is displaced or if conservative treatment fails
• Physical therapy alone if the fracture is truly minimal

Patient Experience

Patients may feel discomfort initially, managed with pain medications. Swelling and limited mobility are common but typically improve over time. The use of a sling or immobilizer can be cumbersome, but it’s necessary to ensure proper healing. Regular follow-up visits ensure the bone is healing correctly and allow for adjustments in treatment if needed.