23660 Open treatment of acute shoulder dislocation

Name of the Procedure:

Open Treatment of Acute Shoulder Dislocation

Summary

An open treatment of acute shoulder dislocation is a surgical procedure performed to relocate a dislocated shoulder that has not responded to non-surgical treatments. The procedure involves making an incision to access the shoulder joint directly and reposition the dislocated bones back into place.

Purpose

This procedure addresses a dislocated shoulder, where the upper arm bone is forced out of its usual position in the shoulder socket. The goals are to relieve pain, restore normal range of motion, and prevent recurrent dislocations.

Indications

• Severe shoulder pain and inability to move the arm
• Visible deformity or displacement of the shoulder joint
• Failure of closed reduction techniques to reposition the shoulder
• Recurrent shoulder dislocations
• Associated tendon, ligament, or bone damage requiring surgical repair

Preparation

• Fasting for 6-8 hours before surgery
• Discontinuation or adjustment of certain medications, as advised by the doctor
• Preoperative imaging tests (e.g., X-rays, MRI) to assess the extent of the dislocation and associated damage
• Preoperative consultation with the surgical and anesthesia team

Procedure Description

1. The patient is placed under general anesthesia.
2. An incision is made near the shoulder joint.
3. The surgeon carefully exposes the dislocated joint.
4. The dislocated bones are realigned into their proper positions.
5. Any additional repairs to tendons, ligaments, or bones are performed.
6. The incision is closed with sutures or staples, and a dressing is applied.

Duration

The procedure typically takes 1-2 hours.

Setting

The surgery is performed in a hospital operating room or a surgical center.

Personnel

• Orthopedic surgeon
• Anesthesiologist
• Surgical nurses
• Surgical technologists

Risks and Complications

• Infection
• Bleeding
• Nerve or blood vessel damage
• Recurrent dislocation
• Stiffness or limited range of motion
• Reactions to anesthesia

Benefits

• Pain relief
• Restoration of shoulder function and range of motion
• Stabilization of the shoulder joint
• Reduction in the risk of recurrent dislocations

Recovery

• Postoperative pain management with medications
• Use of a sling or immobilizer to protect the shoulder
• Physical therapy to regain strength and mobility, starting a few weeks after surgery
• Restrictions on shoulder movement and lifting for several weeks
• Follow-up appointments to monitor healing

Alternatives

• Closed reduction (non-surgical)
• Physical therapy alone
• Arthroscopic shoulder surgery (if applicable)
• Pros: Less invasive, reduced recovery time for non-surgical options
• Cons: Higher risk of recurrent dislocation, possible incomplete reduction

Patient Experience

• During the procedure, the patient will be under general anesthesia and will not feel any pain.
• Post-surgery, pain and discomfort managed with medications.
• Initial immobilization may lead to some inconvenience and limitation in daily activities.
• Gradual improvement with physical therapy and adherence to postoperative care instructions.