23625 Closed treatment of greater humeral tuberosity fracture; with manipulation

Name of the Procedure:

Closed Treatment of Greater Humeral Tuberosity Fracture with Manipulation

Summary

This procedure involves repositioning and stabilizing a fractured greater tuberosity of the humerus (upper arm bone) without surgical incision. Manipulation is used to realign the bone fragments to promote proper healing.

Purpose

To address fractures of the greater tuberosity of the humerus, typically caused by trauma or injury. The goal is to realign bone fragments to ensure proper healing and restore function to the shoulder joint.

Indications

• Fracture of the greater humeral tuberosity.
• Significant displacement or misalignment of bone fragments.
• Severe pain and limited shoulder movement.
• Patients who are not candidates for surgical intervention.

Preparation

• Fasting for a specified period if sedation is used.
• Adjustments in medication as advised by the healthcare provider.
• Pre-procedure X-rays or CT scans to assess the fracture's extent.

Procedure Description

1. The patient is given local anesthesia, sedation, or general anesthesia based on the requirement.
2. The orthopedic surgeon manually manipulates the arm to realign the fractured bone fragments.
3. Imaging techniques such as fluoroscopy may be used to guide and confirm the correct alignment.
4. Once proper alignment is achieved, the arm is immobilized using a sling, shoulder immobilizer, or brace to maintain the position while healing.

Duration

Approximately 30 minutes to 1 hour, depending on complexity.

Setting

Hospital setting, outpatient clinic, or surgical center.

Personnel

• Orthopedic surgeon
• Anesthesiologist or sedation nurse (if sedation is used)
• Radiologic technologist (if imaging is used)
• Nursing staff

Risks and Complications

• Pain or discomfort during manipulation.
• Re-displacement of the fracture.
• Nerve or blood vessel injury.
• Prolonged immobilization leading to stiffness or muscle atrophy.
• Incomplete healing or malunion.

Benefits

• Non-surgical intervention with a quicker recovery time.
• Realignment of the fractured bone promoting proper healing.
• Restoration of shoulder function and reduction of pain.

Recovery

• Follow-up appointments for X-rays to monitor healing.
• Physical therapy may be recommended for regaining strength and mobility.
• Pain management with prescribed medications.
• Gradual return to normal activities as advised by the healthcare provider.
• Full recovery typically within 6-8 weeks, depending on the patient's health and adherence to recovery protocols.

Alternatives

• Surgical treatment involving open reduction and internal fixation (ORIF).
  • Pros: Direct visualization and precise alignment of the fracture.
  • Cons: Surgical risks, longer recovery time.
• Conservative treatment with immobilization alone.
  • Pros: Non-invasive.
  • Cons: Higher risk of improper healing or prolonged immobilization.

Patient Experience

• During the procedure, patients may feel pressure or mild discomfort if conscious.
• Post-procedure, there might be soreness or swelling.
• Pain management will be provided as needed to ensure comfort.
• Patients should follow all care instructions and attend follow-up appointments for the best outcome.