Tag Archives: shoulder surgery

Broken Shoulder Treatment

In my last post What is a Broken Shoulder I explained all about the causes of broken shoulder and just how common it is to break your shoulder.

In this article I’m going to outline the various treatment options available.

Firstly the good news, most broken shoulders or proximal humerus fractures can be treated without surgery.

If the shoulder break is clean, meaning that there are no bone fragments displaced, the arm will be treated by being placed in a sling.

Eighty-five percent of shoulders which are broken, are nondisplaced, and do not require surgery.

The shoulder cannot be placed in a cast for healing, therefore a sling is worn, giving the shoulder time to heal, and preventing further damage.

Shoulder surgery

When the shoulder is broken due to traumatic injury such as a vehicle accident, or forceful fall, treatment may involve surgery.

If bone fragments are shattered, and shifted out of position, surgery is necessary. The fractured bone may be repositioned and fixated with screws, pins, or plates.

If the fragments are too small, or cannot be correctly positioned, shoulder replacement surgery may be necessary.

Factors that determine Broken Shoulder Treatment

Broken shoulder treatment depends on several factors.

Treatments can include wearing a shoulder sling, surgery to replace bone fragments, or shoulder replacement surgery.

Some important factors in determining the proper treatment are:

  • Age of the patient

  • Patient’s general health-is there pre-existing bone disease?

  • How much time has passed between the shoulder injury and diagnosis or treatment?

  • Bone density – is osteoporosis present?

  • Fracture placement-where is the break located in proximity to the shoulder?

  • Condition and placement of fracture fragments-are the fragments scattered or can they be fixated into place?

  • Extent of nerve and/or soft tissue damage surrounding the break

After any broken shoulder treatment, physical therapy is recommended. Supervised physical therapy exercises can help to preserve range of motion.

Normal recovery can be expected for most patients. Only a small percentage of shoulder fractures result in permanent nerve damage.

A period of immobilization will be necessary for approximately 4-6 weeks.

After the first few weeks of healing, more intensive exercises will decrease arm stiffness, and improve the shoulder’s range of motion.

A Broken shoulder is a great inconvenience, but can be managed with proper diagnosis and treatment.

I have produced a complete shoulder relief program that could help you relieve shoulder pain and rehabilitate your shoulder.

Always check with your doctor before doing any exercise and stop the exercise immediately if it causes pain.

—>CLICK HERE to order My complete Shoulder Program to rehabilitate your shoulder pain<—

Kind Regards,
Tim Allardyce DO MCSP SRP

Related Articles:

What is a Broken Shoulder

Should I Have Shoulder Surgery

 

Arthroscopic Shoulder Surgery

What Is Arthroscopic Surgery?

Arthroscopic shoulder surgery is more commonly called keyhole surgery. It involves using an arthroscope to diagnose and treat joint problems.

An arthroscope allows surgeons to literally look within the joint, without making large incisions in the skin. (The word arthroscope is derived from two Greek words, arthro or joint, and skopein – to look.)

How Is Arthroscopic Surgery Performed?

An orthopaedic surgeon inserts a narrow tube, containing a fiber-optic video camera, into the shoulder joint area.

The joint is then viewed on a monitor, which is transmitted from the arthroscope. The incision made for arthroscopic shoulder surgery is about the size of a buttonhole, and this procedure works for relatively uncomplicated shoulder problems.

Common Arthroscopic Shoulder Procedures

A variety of joint conditions may be diagnosed or treated with arthroscopic surgery. Along with the shoulder, arthroscopic surgery is also used on knees, ankles, hips, wrists, and elbows. Some common conditions which may be treated with arthroscopic surgery include:

  • Torn ligaments and tendons surrounding joints
  • Bone spurs or loose bone fragments
  • Inflamed joint linings
  • Damaged or torn cartilage
  • Joint infections
  • Removal of inflamed tissue, excessive scar tissue, or loose cartilage
  • Repairing recurrent shoulder dislocation

Some less common arthroscopic procedures may include fracture repair, nerve release, and cyst extension. Many times, arthroscopic shoulder surgery can correct problems such as a torn cartilage ring (labrum), shoulder instability, or damaged biceps tendons. Shoulder impingement, and problems associated with arthritis may also be corrected. Shoulder arthroscopy is sometimes used for rotator cuff tears if the injury is not too extensive.

What happens before Arthroscopic Shoulder Surgery?

The orthopaedic surgeon will obtain medical records from the patient’s primary physician. Some medications may need to be stopped temporarily, prior to surgery. Other diagnostic tests may be ordered also, to insure a safe surgery. Local or general anesthesia will be administered at the hospital, depending on the extent of shoulder surgery you are having.

Local anesthesia is injected to block pain, in a defined area, and the patient remains awake during surgery. A general anesthesia is delivered intravenously, and will put you to sleep through the surgery. If the patient is generally in good physical health, the arthroscopic shoulder surgery can be performed on an outpatient basis, with no overnight hospital stay.

Arthroscopic Surgery Procedure

In the operating room, the patient may be placed in the beach chair position, or the lateral decubitus position. The beach chair position is similar to sitting in a reclining chair. In the lateral decubitus position, the patient is on his or her side on the operating table. The position selected, is based on the procedure being performed, as well as the surgeon’s training and preference.

The surgical team will remove any hair around the area to be addressed. An antiseptic solution is then spread over the entire shoulder, to prevent infection. The shoulder is covered with sterile drapes. The forearm is placed in a holding device in order to keep it from moving during surgery.

The surgeon will inject fluid into the shoulder. This inflates the joint so that it is easier to see various structures in the shoulder through the arthroscope. A very small incision is made for the arthroscope. Several separate incisions may be made for small specialized instruments necessary for the procedure. Instruments may be necessary for grasping, shaving, suture passing, knot tying, and cutting. Following surgery, the incisions are closed with stitches, or steri-strips, and covered with a larger bandage.

I hope this helps you to understand what is involved in Arthroscopic Shoulder Surgery. For further information follow the link below to my more detailed article

Link: Arthroscopic Shoulder Surgery

Do claim your free shoulder pain report with more free tips and advice for relieving shoulder pain. Just enter your name and email address to receive this valuable guide.

Kind Regards,
Tim Allardyce DO MCSP SRP

Exercises For Shoulder Pain

Arthroscopic Rotator Cuff Surgery

With Arthroscopic  surgery the Rotator Cuff repair  is done by a series of small cuts around the shoulder. Flexible wires called “portals” are introduced through the cuts. These enable the surgeon to see and assess the shoulder damage.

Removal of spurs from the underside of the acromion and repair of the rotator cuff tear are done through the portals themselves using flexible wires capable of carrying various cutting and suturing instruments within themselves in to the joint. This procedure requires a highly proficient and experienced orthopedic surgeon.

Advantage of arthroscopic surgery

The advantage of arthroscopic surgery is that postoperative pain, recovery and rehabilitation are comparatively better. But open shoulder surgery and mini open surgeries provide assured and long term results, especially if the initial rotator cuff tear is very large.

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Mini Open Repair Rotator Cuff Surgery

Mini open repair Rotator Cuff Surgery is a cross between the open and arthroscopic repair.

With Mini open repair the incision is only about 4 cm long. The deltoid muscle is not cut open in this method. Instead, an arthroscope is used to assess the damage and remove the bony fragments of spurs in the underside of the acromion.

Subsequently, the torn rotator cuff tendon is reattached to the humeral head. The incision is then closed in layers.

An advantage of mini open rotator cuff surgery is that recovery is generally quicker than with fully open surgery.

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Open Repair Rotator Cuff Surgery

In open repair rotator cuff surgery a small incision of is made over the shoulder joint. The deltoid muscle, which covers the shoulder joint, is exposed. It is then cut to gain access to the tear.

Re-attaching of the torn rotator cuff tendon to the bone closes the tear. Any bony fragments or spurs are also removed during the procedure. The deltoid muscle is again sutured together. Then the tissues under the skin, and finally the skin are closed.

The results of open rotator cuff surgery provide are generally very good, but disadvantages are that compared to arthroscopic surgery the postoperative pain can be worse, and recovery and rehabilitation takes longer.

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Rotator Cuff Surgery Options

Shoulder surgery is sometimes necessary to treat rotator cuff injuries such as rotator cuff tears. For example, if the rotator cuff injury is accompanied with a decrease in strength of the affected shoulder joint then the injury may require surgery.

There are three different types of shoulder surgery for rotator cuff injuries. These are

1. Open rotator cuff repair
2. Mini open rotator cuff repair
3. Arthroscopic surgery

In my next posts I will examine these different types of rotator cuff surgery in more detail.

To get your copy of my FREE Shoulder Pain Relief Special Report just enter your details in the box above.

Do you Need Rotator Cuff Surgery?

Before deciding to have Rotator Cuff Surgery make sure that you have considered other treatment options such as shoulder exercises and pain relief injections first.

Shoulder surgery is however sometimes required for rotator cuff tears, especially if accompanied with a decrease in strength of the affected shoulder joint. There are three types of surgical repair:

1. Open repair

2. Mini open repair

3. Arthroscopic repair

All of the above methods give fairly similar improvement in pain, functional level and patient satisfaction. The choice of the procedure really depends upon the proficiency of the surgeon, anatomy of the involved area and cosmetic considerations.

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How to Treat Shoulder Bursitis

The first step in treating shoulder bursitis is to reduce shoulder inflammation. I always tell my patients that prevention is the best cure.  I know that it is difficult, but you must try to avoid doing things that cause the inflammation. For example, do not reach for things if that action causes pain.

If the pain persists anti-inflammatory medicines be required. However, anti-inflammatory drugs should not be taken continuously.

Once the initial inflammation subsides, some simple shoulder exercises should be enough to help treat this condition.

If the condition fails to improve, cortisone injections or steroids may be recommended by your doctor and in a small number of cases shoulder surgery may be required.

For further information see the following links:

Shoulder Bursitis

Shoulder Bursitis Treatment

Bursitis Surgery

Shoulder Surgery

Do you need a Shoulder X-Ray?

The first reason to x-ray a painful shoulder is if you believe that there has been any injury to the bone such as a fracture.

X-rays do not show up soft tissue such as muscle and tendons but if you have landed on your arm or shoulder then you may have fractured the bone. Having shoulder x-rays done can also help to prove that it is not from a fracture, so helping to diagnose by a process of elimination.

Other forms of radiography such as x-rays with contrast dyes or ultra-sound can also help to show up more information if it is not a bone-related disorder.

If your doctor recommends x-rays to examine your shoulder pain then what he or she wants to look at is the bones of the shoulder and perhaps the joints between these bones.

For further information about Shoulder X-Rays click the link below:

Shoulder Pain X-Rays

How to Use a Sling After Shoulder Surgery

After shoulder surgery, you may well be prescribed a sling to support the shoulder, and also to warn other people that you have an injured shoulder. The latter is particularly important when being in crowded areas where its likely people will bump into you.

A sling can also have a negative effect however, so should not be worn all the time unless specifically advised by your doctor or physical therapist.

The shoulder is designed to move, so immobilizing it with a sling can cause secondary stiffness or frozen shoulder. This is not great news for anyone recovering from shoulder surgery.

My advice is to follow the instructions of your consultant surgeon. If he or she hasn’t given you advice about how to use your shoulder sling, then ask them.