Closed treatment of shoulder dislocation, with manipulation; without anesthesia
CPT4 code
Name of the Procedure:
Closed Treatment of Shoulder Dislocation, with Manipulation; without Anesthesia
(Common Name: Shoulder Reduction)
Summary
In this procedure, a healthcare provider manually manipulates the shoulder to return a dislocated joint back to its normal position without the use of anesthesia.
Purpose
This procedure addresses the issue of shoulder dislocation, where the upper arm bone pops out of the shoulder socket. The goal is to reposition the shoulder quickly to relieve pain and restore function.
Indications
- Sudden onset of intense shoulder pain and inability to move the shoulder.
- Visible deformity or swelling of the shoulder.
- Previous history of shoulder dislocations.
- Recent traumatic injury to the shoulder.
Preparation
- No specific fasting or medication adjustments are typically required.
- The patient may undergo diagnostic imaging such as X-rays to assess the dislocation and ensure no fractures are present.
Procedure Description
- Initial Assessment: The healthcare provider examines the injured shoulder.
- Manipulation: Using specific techniques, the provider will gently manipulate the arm and shoulder to guide the joint back into place.
- Post-reduction Assessment: Following reduction, the provider reassesses the shoulder to confirm proper alignment.
Tools/Equipment:
- None specific; often performed with hands.
- Imaging equipment for pre- and post-assessment.
No anesthesia is used, so the patient must be able to tolerate the short but intense pain.
Duration
The procedure typically takes about 5-10 minutes.
Setting
The procedure is commonly performed in an emergency department, urgent care center, or outpatient clinic.
Personnel
- Primary healthcare provider (e.g., physician, orthopedic specialist).
- Nurses or medical assistants to provide support.
Risks and Complications
- Risk of pain and discomfort during the procedure.
- Potential for nerve or blood vessel injury.
- Rare chance of fractures.
- Possible recurrent dislocations in patients with unstable joints.
Benefits
- Immediate relief from pain.
- Restoration of shoulder function.
- Prevention of muscle spasms and further injury.
Recovery
- Post-reduction immobilization with a sling or shoulder immobilizer for a few days.
- Instructions for ice application and pain management.
- Physical therapy may be recommended to strengthen shoulder muscles.
- Follow-up appointments to monitor healing and prevent recurrence.
Alternatives
- Surgical intervention if closed reduction is unsuccessful or contraindicated.
- Use of anesthesia for patients unable to tolerate manipulation without pain relief.
Patient Experience
Patients typically experience intense, brief pain during the manipulation. Post-procedure, pain often subsides quickly, but soreness and bruising may persist. Pain relief measures include ice, medications, and rest.