Open treatment of sternoclavicular dislocation, acute or chronic
CPT4 code
Name of the Procedure:
Open Treatment of Sternoclavicular (SC) Dislocation, Acute or Chronic
Summary
This surgical procedure involves the realignment and stabilization of a dislocated sternoclavicular joint, the joint connecting the collarbone (clavicle) to the breastbone (sternum). The surgery is performed through an open incision to directly visualize and manipulate the joint.
Purpose
The procedure addresses both acute (recent) and chronic (long-standing) dislocations of the sternoclavicular joint. The goals are to alleviate pain, restore joint function, and prevent any complications arising from the dislocation, such as compression of nearby vital structures.
Indications
- Severe pain at the sternoclavicular joint
- Noticeable deformity or bulging of the joint
- Difficulty or pain when moving the shoulder
- Chronic instability of the SC joint
- Failure of non-surgical management, such as physical therapy or closed reduction
Preparation
- Fasting for at least 6-8 hours before the procedure to prepare for anesthesia
- Stopping certain medications, such as blood thinners, as advised by your doctor
- Pre-operative imaging studies like X-rays or CT scans to assess the extent of dislocation
- Complete blood work and other routine pre-surgical assessments
Procedure Description
- Anesthesia: General anesthesia is administered so the patient is asleep and pain-free.
- Incision: A small incision is made over the SC joint.
- Exposure: Muscles and tissues are gently moved aside to expose the dislocated joint.
- Reduction: The dislocation is manually realigned.
- Stabilization: The joint is stabilized using hardware such as screws or surgical sutures.
- Closing: The incision is closed with sutures or surgical staples, and a sterile dressing is applied.
Duration
The procedure typically takes about 1 to 2 hours, depending on the complexity of the dislocation.
Setting
The procedure is performed in a hospital or surgical center's operating room.
Personnel
- Orthopedic or thoracic surgeon
- Anesthesiologist
- Surgical nurses and technicians
- Post-operative recovery team
Risks and Complications
- Infection at the surgical site
- Bleeding or blood clots
- Injury to nearby structures such as nerves or blood vessels
- Persistent pain or stiffness
- Failure of the joint to remain stabilized
- Adverse reactions to anesthesia
Benefits
- Relief from pain and discomfort
- Improved shoulder and arm function
- Prevention of further complications caused by the dislocation
- Enhanced quality of life with restored joint stability
Recovery
- Pain management with prescribed medications
- Keeping the arm in a sling to immobilize the joint as it heals
- Gradual, supervised physical therapy to regain strength and mobility
- Avoiding heavy lifting or strenuous activities for several weeks
- Follow-up visits to monitor healing and remove sutures/staples
Alternatives
- Non-surgical treatments like physical therapy or closed reduction
- Minimally invasive procedures if applicable
- Pros of alternatives: less risk, shorter recovery time
- Cons: may be less effective for chronic or severe dislocations
Patient Experience
- Expect some pain and discomfort immediately after the surgery, manageable with medication.
- Initial restricted movement and use of a sling.
- Gradual return to normal activities with a focus on careful rehabilitation.
- Emotional support and reassurance from healthcare providers to ensure a smooth recovery.