23585 Open treatment of scapular fracture (body, glenoid or acromion) includes internal fixation, when performed

Name of the Procedure:

Open Treatment of Scapular Fracture (Body, Glenoid, or Acromion) with Internal Fixation

Summary

This surgical procedure involves repairing a fractured scapula (shoulder blade) by exposing the bone through an incision, aligning the bone fragments, and securing them with internal fixation devices such as plates and screws.

Purpose

The procedure addresses fractures of the scapula, which can impair shoulder function and cause significant pain. The goal is to realign the broken bone fragments, stabilize the fracture, and promote healing, ultimately restoring normal shoulder function and reducing pain.

Indications

• Severe or displaced scapular fractures
• Fractures involving the glenoid fossa, which affect shoulder joint stability
• High-energy trauma causing multiple bone fractures
• Patients with fractures causing nerve or blood vessel damage

Preparation

• Patients will need to fast for at least 8 hours before the surgery.
• Medication adjustments may be necessary, particularly for blood thinners.
• Preoperative imaging tests like X-rays or CT scans are required to assess the extent of the fracture.
• Blood tests and other assessments to ensure fitness for anesthesia.

Procedure Description

1. Patient is placed under general anesthesia.
2. An incision is made over the scapula to expose the fracture site.
3. The bone fragments are realigned to their proper position.
4. Internal fixation devices such as plates and screws are applied to secure the fragments.
5. The incision is closed with sutures or staples.
6. A sterile dressing is applied to the surgical site.

Duration

The procedure typically takes about 2 to 3 hours.

Setting

The procedure is performed in a hospital operating room under sterile conditions.

Personnel

• Orthopedic surgeon
• Anesthesiologist
• Surgical nurses
• Surgical technologist

Risks and Complications

• Infection at the surgical site
• Blood clots
• Nerve or blood vessel injury
• Non-union or malunion of the fracture
• Hardware irritation or failure

Benefits

• Stabilization and healing of the scapular fracture
• Restoration of shoulder function and mobility
• Reduction in pain and improvement in quality of life
• Prevention of long-term complications such as joint instability

Recovery

• Patients may need to wear a sling to immobilize the shoulder for a few weeks.
• Initial pain management with medications.
• Physical therapy will be required to regain strength and range of motion.
• Full recovery can take several months, with follow-up appointments to monitor healing.

Alternatives

• Non-surgical management with immobilization and physical therapy (suitable for less severe fractures).
• Minimally invasive procedures (though not always feasible for complex fractures).

Patient Experience

• The patient will be under general anesthesia during the procedure and will not feel pain.
• Postoperative pain and swelling are common but manageable with medications.
• Physical therapy is crucial for regaining shoulder function, and the patient might experience temporary discomfort during exercises.