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Strapping; shoulder (eg, Velpeau)

CPT4 code

Name of the Procedure:

Strapping; shoulder (e.g., Velpeau)

Summary

Strapping of the shoulder, commonly referred to as the Velpeau bandage technique, involves the use of adhesive straps or bandages to immobilize the shoulder joint. This method ensures that the shoulder remains in a stable position to promote healing.

Purpose

The primary purpose of shoulder strapping is to immobilize the shoulder to allow for proper healing following injuries or surgical procedures. It helps in reducing pain, preventing further damage, and ensuring correct alignment during the recovery process.

Indications

  • Shoulder dislocations.
  • Fractures of the clavicle or humerus.
  • Soft tissue injuries, like rotator cuff tears or strains.
  • Post-surgical stabilization.

Patients who have experienced trauma to the shoulder area or those who have undergone surgery are suitable candidates for this procedure.

Preparation

Patients may need the following preparations:

  • No specific fasting or medication adjustments.
  • Diagnostic imaging tests such as X-rays or MRI to assess the injury.
  • Wearing comfortable, loose-fitting clothing for easy access to the shoulder area.

Procedure Description

  1. The patient is seated or lying down in a comfortable position with the shoulder in a neutral or slightly abducted position.
  2. A protective padding is applied to the pressure points to avoid skin irritation.
  3. Adhesive straps or bandages are carefully applied around the chest and the affected arm, ensuring the shoulder is immobilized.
  4. Adjustments are made to ensure the straps are snug but not too tight to constrict blood flow. Tools and equipment used include adhesive bandages or elastic straps, padding materials, and sometimes a sling for additional support. Anesthesia is generally not required, but mild sedation may be used if the patient is in significant pain.

Duration

The procedure typically takes around 15-30 minutes.

Setting

This procedure can be performed in a hospital, outpatient clinic, or sometimes in an emergency room setting.

Personnel

  • Orthopedic surgeon or physician.
  • Nurse or medical assistant.

Risks and Complications

  • Skin irritation or breakdown due to adhesive materials.
  • Restricted blood flow if the straps are too tight.
  • Potential for reduced range of motion if immobilization is prolonged.

Benefits

  • Stabilization of the shoulder, reducing pain and promoting healing.
  • Prevention of further injury or displacement.
  • Rapid recovery and return to normal activities post-immobilization.

Recovery

  • Patients are advised to avoid strenuous activities and follow their doctor’s specific instructions.
  • Regular follow-up appointments to monitor healing progress are essential.
  • Recovery time varies but generally ranges from several weeks to a few months, depending on the severity of the injury.

Alternatives

  • Use of a shoulder immobilizer or brace.
  • Surgical intervention for more severe cases.
  • Physical therapy for less severe injuries.

Each alternative has its pros and cons. For example, braces may offer more flexibility, whereas surgery provides a more permanent solution but comes with higher risks and longer recovery times.

Patient Experience

Patients might experience some discomfort or tightness due to the immobilization. Pain management through over-the-counter pain relievers or prescribed medications may be necessary. Proper skin care and monitoring for any signs of irritation or infection are crucial for comfort and safety.

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