23515 Open treatment of clavicular fracture, includes internal fixation, when performed

Name of the Procedure:

Open Treatment of Clavicular Fracture, Includes Internal Fixation

Summary

In an open treatment of a clavicular fracture, the surgeon makes an incision over the broken clavicle (collarbone), aligns the broken bones, and secures them with plates or screws to ensure proper healing.

Purpose

This surgery addresses broken clavicles that won't heal correctly on their own. It aims to stabilize the fracture, promote proper bone healing, relieve pain, and restore shoulder function.

Indications

• Severe or displaced clavicle fractures.
• Non-union or malunion of a previously broken clavicle.
• Significant bone fragmentation.
• Persistent pain or functional impairment due to the fracture.

Preparation

• Patients are usually required to fast for at least 8 hours before surgery.
• Blood tests, X-rays, or CT scans may be performed for surgical planning.
• Adjustments in regular medications, especially blood thinners, may be advised.

Procedure Description

1. Anesthesia: General anesthesia is administered.
2. Incision: A precise incision is made over the fracture site.
3. Exposure: The broken ends of the clavicle are exposed.
4. Reduction: The bone fragments are aligned into their natural position.
5. Fixation: Metal plates and screws are used to secure the fragments.
6. Closure: The incision is closed with sutures or staples.

Duration

The procedure typically takes about 1 to 2 hours.

Setting

This procedure is performed in a hospital operating room.

Personnel

• Surgeon: Performs the operation.
• Nurses: Assist with preparation and during the procedure.
• Anesthesiologist: Manages anesthesia and monitors the patient.

Risks and Complications

• Infection at the surgical site.
• Blood vessel or nerve injury.
• Poor bone healing (non-union).
• Screws or plates may need removal later.
• Anesthetic risks, such as reactions or breathing problems.

Benefits

• Proper bone healing and alignment.
• Pain reduction.
• Improved shoulder function.
• Lower risk of long-term deformity or disability.

Recovery

• Immediate post-op care includes pain management and immobilization with a sling.
• Physical therapy typically starts a few weeks post-surgery.
• Recovery time varies but generally spans 6 to 12 weeks.
• Follow-up appointments monitor healing progress.

Alternatives

• Non-surgical Management: Use of a sling and physical therapy.
  • Pros: No surgical risks.
  • Cons: Higher likelihood of poor alignment, prolonged healing, and potential chronic pain or functional issues.

Patient Experience

• During Procedure: Under general anesthesia, no sensation during surgery.
• Post-Procedure: Initial pain managed with medications; soreness and limited arm movement for several weeks.
• Long-term: Gradual improvement in arm strength and mobility with physical therapy.