23665 Closed treatment of shoulder dislocation, with fracture of greater humeral tuberosity, with manipulation

Name of the Procedure:

Closed Treatment of Shoulder Dislocation, with Fracture of Greater Humeral Tuberosity, with Manipulation

Summary

In layman's terms, this procedure involves setting a dislocated shoulder back in place and aligning a broken part of the upper arm bone, all without needing to make any surgical cuts. The doctor uses specific movements to guide the bones back into their proper positions.

Purpose

This procedure addresses a dislocated shoulder accompanied by a fracture of the greater tuberosity of the humerus. The goals are to relieve pain, restore normal shoulder alignment, and allow proper healing of the fracture.

Indications

• Shoulder dislocation with associated fracture of the greater tuberosity.
• Severe shoulder pain and inability to move the arm.
• Swelling and visible deformity of the shoulder.
• X-ray or MRI confirming the dislocation and fracture.

Preparation

• The patient may be instructed to fast for a few hours prior to the procedure.
• Medication adjustments might be necessary, especially for blood thinners.
• Pre-procedure imaging tests like X-rays are required to assess the dislocation and fracture.

Procedure Description

1. The patient will be given anesthesia or sedation to minimize pain and discomfort.
2. The healthcare provider will use traction and specific manipulative techniques to guide the shoulder joint back into place and align the greater tuberosity.
3. Post-reduction, imaging tests will be done to confirm the successful relocation and alignment.

Duration

The procedure typically takes about 30 minutes to an hour, depending on the complexity.

Setting

The procedure is performed in a hospital emergency department or an outpatient surgical center.

Personnel

• Orthopedic surgeon or emergency physician
• Nurses
• Anesthesiologist or sedation provider

Risks and Complications

• Nerve or blood vessel injury
• Incomplete reduction requiring additional procedures
• Recurrent shoulder dislocations
• Infection
• Prolonged pain and stiffness

Benefits

• Relief from pain and deformity
• Restored shoulder function and mobility
• Stabilized fracture allowing for natural bone healing
• Rapid improvement within days to weeks post-procedure

Recovery

• The patient may need to wear a sling for several weeks.
• Physical therapy exercises will be recommended to restore mobility and strength.
• Follow-up appointments are necessary to monitor healing.
• Full recovery can range from a few weeks to a few months depending on the individual case.

Alternatives

• Open surgical reduction and fixation
• Non-operative treatment with immobilization (may be less effective for combined dislocation and fracture)
• Pros and cons: Surgery may offer more stability but comes with higher risks, while non-operative treatment is less invasive but may not fully correct the alignment.

Patient Experience

• During the procedure, you may be under sedation or anesthesia to prevent pain.
• Post-procedure, mild to moderate pain can be expected, manageable with prescribed pain relief.
• Swelling and bruising around the shoulder are common.
• Using a sling can be uncomfortable but is essential for proper healing.
• Physical therapy will help in regaining movement and strength gradually.