23570 Closed treatment of scapular fracture; without manipulation

Name of the Procedure:

Closed Treatment of Scapular Fracture Without Manipulation

Summary

This procedure involves managing a fracture of the scapula (shoulder blade) without surgically manipulating or realigning the bones. It typically includes the use of immobilization devices like slings to allow the bone to heal naturally.

Purpose

This procedure addresses fractures to the scapula, helping ensure proper bone healing by immobilizing the area. The goal is to allow the bone to heal without surgical intervention, reducing discomfort and restoring normal function.

Indications

• Fractures of the scapula
• Minimal bone displacement
• Stable fractures not requiring surgical realignment
• A patient in good general health who can comply with immobilization protocols

Preparation

• Patients may need an X-ray or CT scan to assess the fracture.
• Fasting or medication adjustments are generally not required for this non-surgical procedure.

Procedure Description

1. The affected arm is positioned in a sling or shoulder immobilizer.
2. Gradual range-of-motion exercises may be recommended after a certain period.
3. Regular follow-up imaging tests (X-ray or CT scan) to monitor healing progress.

Duration

Usually takes around 20-30 minutes for the initial setup. Follow-up visits for monitoring may vary in length.

Setting

• Outpatient clinic
• Emergency department
• Sometimes in primary care settings

Personnel

• Attending physician or orthopedic specialist
• Nursing staff for setup and patient instructions
• Radiologist for imaging assessments

Risks and Complications

• Potential for non-union or delayed bone healing
• Risk of stiffness or loss of shoulder mobility
• Rare complications like nerve or vascular injury from the fracture itself

Benefits

• Non-invasive approach with minimal risk compared to surgical treatment
• May quickly reduce pain through proper immobilization
• Healing occurs naturally with good compliance to rehabilitation protocols

Recovery

• Frequent follow-up appointments to monitor healing
• Patient education on limiting shoulder movement
• Gradual introduction of physical therapy exercises
• Full recovery expected within 6-12 weeks, depending on fracture severity

Alternatives

• Surgical intervention if the fracture is severe or displaced
• Use of external fixation devices in more complex cases
• Pros of this closed treatment: non-invasive, less risk, quicker initial recovery, cons: may not be suitable for all types of fractures

Patient Experience

• Initial setup is painless, mostly involving fitting of a sling or immobilizer
• Minor discomfort from immobilization but typically well-tolerated
• Pain can be managed with OTC pain relievers and rest
• Gradual improvement in mobility and pain relief as healing progresses