23655 Closed treatment of shoulder dislocation, with manipulation; requiring anesthesia

Name of the Procedure:

Closed Treatment of Shoulder Dislocation, with Manipulation; Requiring Anesthesia
Common names: Shoulder Reduction, Closed Reduction of Shoulder Dislocation

Summary

Closed treatment of shoulder dislocation involves manually realigning a dislocated shoulder joint back to its normal position without the need for surgical incisions. This procedure is performed under anesthesia to minimize pain and discomfort.

Purpose

The primary goal of this procedure is to address a dislocated shoulder, a condition where the top of the upper arm bone (humerus) slips out of its usual position in the shoulder socket. This treatment aims to realign the bone, relieve pain, restore function, and prevent further complications.

Indications

• Severe shoulder pain and inability to move the arm
• Visible deformity or swelling around the shoulder
• History of traumatic injury to the shoulder
• X-rays confirming shoulder dislocation

Preparation

• Fasting for a specific period before the procedure (usually 6-8 hours) if general anesthesia is to be used
• Stopping certain medications as advised by the physician
• Undergoing imaging tests like X-rays to confirm the dislocation and plan the reduction

Procedure Description

1. Anesthesia: The patient receives either general anesthesia or sedative medications to ensure they are unconscious or very relaxed.
2. Manipulation: The physician performs specific techniques and movements to gently manipulate the shoulder back into its socket.
3. Verification: Post-reduction X-rays are taken to confirm the shoulder is properly aligned.
4. Immobilization: A sling or shoulder immobilizer is often used to keep the shoulder in place and prevent further injury.

Tools and Equipment:

• X-ray machine
• Anesthetic drugs and monitoring equipment
• Immobility devices like slings or braces

Duration

The procedure itself typically takes about 15-30 minutes, although the total time including anesthesia and recovery may extend to a few hours.

Setting

This procedure is usually performed in a hospital, emergency room, or outpatient surgical center.

Personnel

• Orthopedic surgeon or emergency medicine physician
• Anesthesiologist or nurse anesthetist
• Nurses and medical support staff

Risks and Complications

• Pain or discomfort during or after the procedure
• Risk of re-dislocation or instability
• Nerve or blood vessel injury
• Fractures
• Infection

Benefits

• Immediate relief from pain and discomfort
• Restoration of normal shoulder function and mobility
• Reduced risk of long-term joint damage and arthritis

Recovery

• Patient may need to rest and immobilize the shoulder for a few days.
• Pain management with prescribed medications.
• Physical therapy may be recommended to restore strength and mobility.
• Follow-up appointments to monitor recovery.
• Generally, full recovery can take several weeks.

Alternatives

• Non-surgical management: Only in cases where manipulation is not necessary.
• Surgical treatment: Open reduction might be required for complex or recurrent dislocations.
• Physical therapy: To manage mild instability and strengthen shoulder muscles.

Patient Experience

• During the procedure, patients are under anesthesia and should not feel pain.
• Post-procedure, there might be soreness or discomfort, managed by pain relief medications.
• Guided physical therapy can ease recovery and return to normal activities.