23620 Closed treatment of greater humeral tuberosity fracture; without manipulation

Name of the Procedure:

Closed treatment of greater humeral tuberosity fracture; without manipulation

Summary

This procedure involves treating a fracture of the greater tuberosity of the upper arm bone (humerus) without physically adjusting or moving the bone fragments into place. It's a non-invasive approach focusing on stabilizing and allowing the bone to heal naturally.

Purpose

The procedure addresses fractures of the greater tuberosity, the part of the humerus where shoulder muscles attach. The goal is to manage pain, ensure stability, and promote natural healing without the need for surgical intervention.

Indications

• Pain in the shoulder area following an injury
• Swelling and bruising around the shoulder
• Restricted or painful shoulder movement, specifically after trauma
• X-ray confirming a non-displaced greater tuberosity fracture

Preparation

• Patient may need to undergo an X-ray or MRI to confirm the fracture
• No specific fasting or medication adjustments are generally required
• Patients should disclose any medications or allergies to healthcare providers

Procedure Description

1. Assessment: The physician performs a physical examination and reviews imaging.
2. Immobilization: The arm is usually placed in a sling or shoulder immobilizer to keep the shoulder and arm stable.
3. Pain Management: Over-the-counter pain medications or prescribed analgesics are provided as needed.
4. Follow-up: Regular follow-up appointments are scheduled to monitor healing progress via physical exams and periodic X-rays.

Duration

The initial immobilization and instruction typically take about 30 minutes. Follow-up evaluations may vary in duration.

Setting

The procedure is usually performed in an outpatient clinic or hospital setting.

Personnel

• Orthopedic physician or surgeon
• Nurse or medical assistant for support and education

Risks and Complications

• Minimal risks as there's no surgery involved
• Possible complications include improper healing, persistent pain, and decreased shoulder function
• Rarely, the need for surgical intervention if the bone does not heal correctly

Benefits

• Non-invasive treatment reducing surgical risks
• Pain relief and stabilization of the shoulder
• Natural bone healing process
• Most patients experience improvement in shoulder function within a few weeks to months

Recovery

• Immobilization typically lasts for several weeks
• Gradual return to shoulder movement and strength through physical therapy
• Follow-up visits to monitor healing
• Instructions may include avoiding heavy lifting or strenuous activity until fully healed

Alternatives

• Open surgical treatment if the fracture is displaced or not healing properly
• Manipulation of the bone fragments if realignment is necessary
• Pros: Surgery may provide quicker stabilization and healing
• Cons: Surgery involves higher risk, more pain, and longer recovery

Patient Experience

• During the procedure: Minimal discomfort as it is non-invasive
• After the procedure: Possible soreness in the shoulder, managed with pain medications
• Pain management is straightforward and aims at keeping patients comfortable while promoting healing through natural bone alignment.