CPT® Code 23680

Open treatment of shoulder dislocation, with surgical or anatomical neck fracture, includes internal fixation, when performed

The procedure described by CPT® Code 23680 refers to the open treatment of a shoulder dislocation that is accompanied by a fracture of the surgical or anatomical neck of the humerus. This procedure involves an open reduction, which means that the dislocated shoulder is surgically repositioned into its correct anatomical location. In cases where there is a fracture of the surgical neck, the greater and lesser tuberosities, which are bony prominences on the humeral head, typically remain attached. This is significant as it influences the surgical approach and fixation techniques used during the procedure. The surgical exposure is generally achieved through an anterior superior or deltopectoral approach, allowing the surgeon to access the shoulder joint effectively. Once the fracture-dislocation is visualized, the surgeon performs a reduction, which is the process of realigning the dislocated joint. Depending on the specific characteristics of the fracture, various fixation methods may be employed to stabilize the shoulder. For instance, unstable oblique or spiral fractures may require the application of a plate for fixation. Other techniques may include creating drill holes in the humeral shaft below the fracture site and using figure-of-eight sutures for stabilization. Additionally, Enders nails, which are a type of intramedullary fixation device, may be utilized along with tension sutures or wires to secure the fracture. This comprehensive approach ensures that both the dislocation and the associated fracture are adequately addressed, promoting optimal healing and recovery for the patient.