Open treatment of shoulder dislocation, with fracture of greater humeral tuberosity, includes internal fixation, when performed
CPT4 code
Name of the Procedure:
Open Treatment of Shoulder Dislocation with Fracture of Greater Humeral Tuberosity (including Internal Fixation)
Summary
The procedure involves surgically treating a dislocated shoulder that is accompanied by a fracture of the greater tuberosity of the humerus. This is achieved by repositioning the dislocated shoulder, aligning the broken bone fragments, and using internal fixation devices like screws or plates to secure them.
Purpose
The procedure aims to:
- Correct a displaced shoulder joint.
- Repair and stabilize the fractured humeral tuberosity.
- Restore normal shoulder mechanics and function.
- Relieve pain and prevent future dislocations or complications.
Indications
- Severe shoulder pain and inability to move the shoulder due to dislocation and fracture.
- Visible deformity and swelling around the shoulder joint.
- Failure of nonsurgical treatments to realign and stabilize the shoulder.
- Patients with active lifestyles or athletes requiring reliable shoulder stability for optimal performance.
Preparation
- Patients may need to fast for 8 hours prior to surgery.
- Adjustments or temporary cessation of certain medications, especially blood thinners.
- Diagnostic imaging (X-rays, MRI, or CT scans) to assess the extent of the injury.
Procedure Description
- Anesthesia: General anesthesia is administered to ensure the patient is unconscious and pain-free.
- Incision: A surgical incision is made near the shoulder to access the dislocated joint and fractured tuberosity.
- Reduction: The surgeon carefully repositions the shoulder joint back into place.
- Fracture Repair: The fractured pieces of the greater humeral tuberosity are aligned and fixed using screws, plates, or other internal fixation devices.
- Closure: The incision is closed with sutures, and a sterile dressing is applied.
Duration
The procedure typically takes 1 to 2 hours, depending on the complexity of the dislocation and fracture.
Setting
The procedure is performed in a hospital operating room.
Personnel
- Orthopedic Surgeon
- Anesthesiologist
- Surgical Nurses
- Surgical Technicians
Risks and Complications
- Infection at the surgical site
- Blood clots
- Damage to nerves or blood vessels
- Incomplete healing or failure of the bone to heal
- Stiffness or reduced range of motion in the shoulder
- Need for additional surgeries
Benefits
- Stabilization and healing of the shoulder joint and fractured tuberosity
- Restoration of shoulder function and strength
- Reduction of pain and prevention of recurrent dislocations
- Improved quality of life and return to daily activities
Recovery
- Post-procedure immobilization using a sling or shoulder immobilizer.
- Pain management with prescribed medications.
- Physical therapy to restore range of motion and strength, starting within a few weeks post-surgery.
- Expected full recovery within 3 to 6 months, but this can vary based on individual healing rates.
Alternatives
- Closed reduction and nonsurgical management (may not be effective for complex fractures).
- Arthroscopic repair (less invasive but not always suitable for severe fractures).
- Pros and cons should be discussed with the healthcare provider, considering factors like severity, patient age, activity level, and overall health.
Patient Experience
- During the procedure: Patient will be under general anesthesia and will not feel anything.
- After the procedure: Some pain and swelling are expected, managed with medications.
- Pain management: Regular use of prescribed pain relievers, ice packs, and physical therapy to enhance comfort and facilitate recovery.