23675 Closed treatment of shoulder dislocation, with surgical or anatomical neck fracture, with manipulation

Name of the Procedure:

Closed treatment of shoulder dislocation, with surgical or anatomical neck fracture, with manipulation

Common Name: Shoulder Reduction with Fracture Management Medical Terms: Closed Reduction of Glenohumeral Dislocation with Fractured Humerus

Summary

This procedure involves repositioning a dislocated shoulder joint and addressing any associated fractures in the upper arm bone (humerus) without making any incisions. Physicians use external manipulation techniques to realign the bones.

Purpose

The procedure addresses the dislocated shoulder joint combined with a fracture in the neck of the humerus. The main goals are to stabilize the shoulder, alleviate pain, restore normal function, and promote proper healing of the fracture.

Indications

This procedure is indicated for patients experiencing:

• Shoulder dislocation with an associated fracture of the surgical or anatomical neck of the humerus.
• Severe pain, inability to move the shoulder, or visible deformity of the shoulder.

Preparation

Patients may be instructed to:

• Fast for a certain period before the procedure if general anesthesia is planned.
• Adjust or stop certain medications, such as blood thinners.
• Undergo diagnostic imaging tests like X-rays or MRIs to assess the extent of the dislocation and fracture.

Procedure Description

1. Anesthesia: The patient might receive sedation or general anesthesia for comfort.
2. Reduction: The healthcare professional will carefully manipulate the shoulder to move the dislocated joint back into its correct position.
3. Fracture Management: The fracture is then stabilized, potentially using a sling or immobilizer.
4. Assessment: Post-reduction X-rays are taken to ensure proper alignment of the joint and fracture.

Duration

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

Setting

This procedure is usually performed in a hospital emergency department or a surgical center.

Personnel

The procedure involves:

• An orthopedic surgeon or emergency medicine physician
• Nurses
• An anesthesiologist or sedation nurse (if sedation or anesthesia is used)

Risks and Complications

Common risks include:

• Pain or discomfort during manipulation
• Loss of range of motion
• Swelling and bruising Rare complications:
• Nerve or blood vessel injury
• Improper bone healing or misalignment
• Recurrence of shoulder dislocation

Benefits

The main benefits include:

• Relief from severe pain and discomfort
• Restoration of shoulder function and range of motion
• Proper healing of the fractured humerus These benefits can be evident immediately, though full recovery takes time.

Recovery

Post-procedure care includes:

• Wearing a sling or immobilizer to protect the shoulder
• Pain management with prescribed medications
• Physical therapy to regain strength and mobility
• Follow-up appointments for X-rays and monitoring recovery Recovery time varies but generally ranges from a few weeks to several months.

Alternatives

Alternative treatments may include:

• Open surgical reduction for more severe cases
• Conservative management with physical therapy alone The choice of alternatives depends on the severity of the dislocation and fracture, and other patient-specific factors.

Patient Experience

During the procedure, patients will either be sedated or under general anesthesia, so they should feel minimal pain. Post-procedure, there might be pain, bruising, and swelling managed by pain medications. Comfort measures include using ice packs and keeping the shoulder immobilized as directed.