Closed treatment of acromioclavicular dislocation; without manipulation
CPT4 code
Name of the Procedure:
Closed Treatment of Acromioclavicular (AC) Dislocation; Without Manipulation
Summary
This procedure involves non-surgical management of a shoulder separation, specifically the dislocation of the acromioclavicular joint, without the need for physically adjusting the bones back into place.
Purpose
The procedure addresses an acromioclavicular dislocation, commonly known as a shoulder separation. The goal is to alleviate pain, reduce inflammation, and help the shoulder heal properly, restoring function without surgical intervention.
Indications
- Visible deformity or “bump” at the top of the shoulder.
- Pain and swelling at the site of dislocation.
- Limited range of motion or difficulty moving the arm.
- Patients for whom surgical intervention is either not preferred or not necessary.
Preparation
- No special preparation like fasting is typically required.
- An examination and possibly an X-ray or MRI to confirm the type and severity of the dislocation.
- Discussion about the procedure, risks, benefits, and postoperative care.
Procedure Description
- The patient is assessed and a treatment plan is discussed.
- Application of a sling or shoulder immobilizer to keep the arm in place and reduce movement.
- Recommendations for pain management, which may include over-the-counter pain relievers or prescribed medications.
- Ice packs are often advised to reduce swelling.
- Instructions on gentle range-of-motion exercises to prevent stiffness as healing progresses.
No anesthesia or sedation is typically required since there is no manipulation involved.
Duration
The initial treatment and instructions can be provided in a single outpatient visit, which usually takes about 30 to 60 minutes.
Setting
The procedure is performed in an outpatient clinic or a physician's office.
Personnel
- Orthopedic physician or primary care doctor.
- Nurse or medical assistant, if needed for support and patient education.
Risks and Complications
- Persistent pain and discomfort.
- Potential for improper healing or shoulder instability.
- Rare: progression to a condition that might require surgical intervention.
Benefits
- Non-invasive with no surgical risks.
- Can effectively reduce pain and swelling.
- Restores shoulder function over time without the need for surgery.
Recovery
- Initial immobilization period of 1-3 weeks depending on severity.
- Gradual return to activities with physical therapy if needed.
- Full recovery can take several weeks to a few months.
- Schedule for follow-up visits to monitor healing progress.
Alternatives
- Surgical intervention for more severe dislocations or failed nonsurgical treatment.
- Physical therapy alone, though it may not be sufficient without initial immobilization.
- Risk of surgery includes infection and longer recovery time, whereas non-invasive treatment minimizes these risks but may not be suitable for severe cases.
Patient Experience
- Initial pain and discomfort managed with medications and ice.
- Use of a sling might be uncomfortable but is necessary for healing.
- Gradual improvement in shoulder function and decrease in pain over weeks.
- Follow-up visits will ensure proper healing and provide adjustments to treatment as needed.
Pain management involves prescribed or over-the-counter medications and physical therapy for comfort and mobility restoration.