23630 Open treatment of greater humeral tuberosity fracture, includes internal fixation, when performed

Name of the Procedure:

Open treatment of greater humeral tuberosity fracture, includes internal fixation
Common name: Open Reduction and Internal Fixation (ORIF) of Greater Humeral Tuberosity Fracture

Summary

This surgical procedure is performed to repair a fracture in the greater tuberosity of the humerus, a part of the shoulder. The procedure involves realigning the bone fragments and securing them with hardware such as screws or plates to ensure proper healing.

Purpose

The procedure addresses fractures of the greater tuberosity of the humerus to restore proper shoulder function and alleviate pain. The goals are to ensure the bones heal in the correct position, maintain shoulder stability, and restore the range of motion.

Indications

• Severe pain and disability due to the fracture.
• Displacement of the bone fragments.
• Failure of non-surgical treatments such as casting or immobilization.
• Active individuals requiring full shoulder function.

Preparation

• Patients may need to abstain from eating or drinking for at least 6-8 hours before surgery.
• Adjustments to regular medications, especially blood thinners, should be discussed with the doctor.
• Pre-surgery tests such as X-rays, MRI, or CT scans to assess the extent of the fracture.
• A pre-operative evaluation by the anesthesiologist.

Procedure Description

1. The patient is positioned and given general anesthesia or a nerve block for sedation and pain control.
2. The surgeon makes an incision over the shoulder to access the fractured bone.
3. Bone fragments are realigned (reduced) to their anatomic position.
4. Internal fixation is performed using screws, plates, or wires to hold the fragments together.
5. The incision is closed with sutures or staples, and a sterile dressing is applied.

Duration

The procedure typically takes about 1 to 2 hours, depending on the complexity of the fracture.

Setting

The procedure is performed in a hospital operating room or a specialized surgical center.

Personnel

• Orthopedic surgeon
• Anesthesiologist
• Surgical nurses
• Radiologic technologist (if intraoperative imaging is used)

Risks and Complications

• Infection
• Bleeding
• Nerve or blood vessel injury
• Hardware failure or irritation
• Delayed bone healing or non-union
• Stiffness and reduced range of motion

Benefits

• Proper alignment and stabilization of the fracture.
• Improved shoulder function.
• Reduced pain and faster recovery compared to non-surgical management.

Recovery

• The arm may be placed in a sling or immobilizer.
• Pain management with prescribed medications.
• Physical therapy to regain strength and mobility.
• Follow-up appointments to monitor healing progress.
• Full recovery can take several months, with restrictions on lifting and heavy use of the arm.

Alternatives

• Non-surgical treatment with immobilization and physical therapy.
• Pros: Avoidance of surgical risks and anesthesia.
• Cons: Higher risk of improper healing, prolonged disability, and reduced function in severe fractures.

Patient Experience

During the procedure, the patient is under anesthesia and will not feel pain. Post-surgery, pain management includes medications and possibly ice packs. Patients may experience discomfort, swelling, and limited mobility initially but can expect gradual improvement with physical therapy and adherence to recovery protocols.