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Shoulder Dislocation

Shoulder Dislocation - Surgery Procedure & Benefits at Curific Health Care

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    What is a Shoulder Dislocation?

    A shoulder dislocation occurs when the upper arm bone (humerus) slips out of the cup-shaped socket (glenoid) in the shoulder blade. Since the shoulder joint is the most flexible in the body, it is particularly susceptible to dislocations.

    Symptoms and Causes

    • Symptoms: Intense pain, swelling, inability to move the shoulder, visible deformity, and possible numbness or tingling in the arm.
    • Causes: Traumatic injuries from sports, falls, or accidents, or instability from repetitive shoulder movements.

    Treatment Options

    1. Non-Surgical Treatments:

      • Immediate medical care to reposition the joint (closed reduction).
      • Pain relief through medication.
      • Physical therapy to restore strength and range of motion.

    2. Surgical Intervention:

      • If the dislocation is severe or recurs frequently, surgery may be required to repair damaged ligaments or stabilize the joint.

    With proper treatment, most people regain full function of the shoulder within a few weeks. However, once dislocated, the joint may be more prone to future dislocations.

    What are the Different Types of Shoulder Dislocation Surgery?

    Different types of shoulder dislocation surgery, along with their procedure, are as follows:

    • Bankart repair surgery: A bankart repair is a surgical technique usually performed to repair recurrent shoulder joint dislocations. During the procedure, the worn-out ligaments are re-attached to the proper place in the shoulder joint, using the objective of rebuilding normal function.
    • Capsular shift surgery: This surgical procedure is performed to tighten the joint capsule. During this procedure, a surgeon uses an arthroscope to tighten the capsule and the ligaments in order to stabilize the shoulder.
    • Latarjet procedure: It is usually recommended for a person with bone loss at the shoulder’s socket. This procedure involves taking a small amount of bone material from the coracoid process (part of the shoulder blade) and transferring it to the front part of the shoulder’s socket. Bone loss in the socket can also be repaired with bone grafts taken from the patient’s iliac crest (part of the pelvic bone) or from a donor. Bone grafts from a donor or bone bank may increase the risk of infection.
    • Remplissage procedure: A healthcare provider usually suggests this procedure if the shoulder’s ball, or humeral head, is damaged by dislocation, causing a condition known as a Hill-Sachs lesion. This procedure involves resurfacing the head and/or filling in the defect by fixing it to part of the rotator cuff.
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      Shoulder Replacement Surgery at Curific Health Care

      How Are Dislocated Shoulders Diagnosed?

      A healthcare provider typically diagnoses a dislocated shoulder by performing the following steps:

      1. Patient History and Symptoms: The doctor will inquire about any past shoulder injuries, the mechanism of injury, and symptoms such as pain, swelling, and the inability to move the shoulder.

      2. Physical Examination: The doctor will physically examine the shoulder to assess for deformity, swelling, and tenderness. They may also test the shoulder’s range of motion and check for nerve or blood vessel involvement.

      3. Diagnostic Tests: To confirm the diagnosis and determine the extent of damage, the following tests may be ordered:

        • X-ray: Helps visualize bone fractures, joint alignment, and possible damage to the socket or humeral head.
        • MRI: Provides detailed images of the soft tissues, such as ligaments, tendons, and muscles, to detect any tears or damage.
        • CT Scan: Offers a more detailed image of bone fractures or structural abnormalities in the shoulder joint.
        • Musculoskeletal Ultrasound: Used to assess soft tissue damage and guide injection therapies if necessary.

      Benefits of Shoulder Dislocation Surgery

      Arthroscopic Bankart repair surgery, compared to traditional open surgery for treating a Bankart tear and dislocated shoulder, offers several advantages:

      • Smaller Incisions: The procedure involves making small incisions, reducing scarring and recovery time.
      • Less Surgical Time: Arthroscopic surgery typically requires less time in the operating room.
      • Minimal Postoperative Pain: Patients generally experience less discomfort post-surgery due to the minimally invasive nature of the procedure.
      • Lower Risk of Complications: With smaller incisions, the likelihood of infection, bleeding, and other complications is reduced.
      • Less Blood Loss: Due to the minimally invasive approach, there is significantly less blood loss.
      • Improved Range of Motion: The surgery helps restore the shoulder’s function, often leading to a better range of motion compared to open surgery.
      • Enhanced Stability: The procedure restores shoulder stability, reducing the risk of repeated dislocations.

      What Should I Expect After the Procedure?

      After shoulder dislocation surgery, your recovery journey will involve several stages. Here’s what you can expect:

      Immediate Post-Op:

      • Recovery Area: After surgery, you will be taken to a recovery area where healthcare professionals monitor your condition as you wake up from anesthesia.

      Pain Management:

      • Pain Relief: Discomfort is common after surgery, but your doctor will prescribe pain medications to help you manage it. Pain may decrease gradually as healing progresses.

      Immobilization:

      • Sling or Shoulder Immobilizer: You may need to wear a sling or shoulder immobilizer for a set period to protect the shoulder and support healing.

      Physical Therapy:

      • Rehabilitation: Physical therapy usually begins soon after surgery to help restore strength, flexibility, and range of motion. A physiotherapist will guide you through appropriate exercises tailored to your recovery.

      Swelling and Bruising:

      • Post-Surgery Swelling: It’s normal to experience swelling and bruising around the shoulder. Applying ice packs and elevating the shoulder can help reduce these effects.

      Limited Mobility:

      • Restricted Movement: In the initial phase of recovery, shoulder movement will be limited, but you will regain full mobility as you continue with physical therapy.

      Driving Restrictions:

      • Driving Guidelines: You may need to refrain from driving until you regain sufficient strength and range of motion in your shoulder. Your surgeon will provide guidelines on when it’s safe to resume driving.

      Return to Work and Activities:

      • Activity Resumption: The time it takes to return to work and daily activities will depend on your recovery progress and job requirements. Jobs that require heavy lifting or physical exertion may require more time off.

      Activity Restrictions:

      • Avoid Strain: Your healthcare team will give you specific instructions on activities to avoid, especially those that could put unnecessary stress on the healing shoulder joint.

      Follow-Up Appointments:

      • Monitoring Recovery: You will need to attend follow-up appointments with your surgeon to ensure proper healing and discuss any adjustments needed for your treatment plan.

      Full Recovery Timeframe:

      • Recovery Duration: Significant improvements are usually seen within a few months, but full recovery could take up to a year, depending on the severity of the injury and the type of surgery performed.

      Possible Complications:

      • Risk of Complications: As with any surgery, risks such as infection, nerve injury, stiffness, or recurrent dislocations are possible. If you notice signs of infection, persistent pain, or other concerns, contact your healthcare provider immediately.

      Recovery Tips After Shoulder Dislocation Surgery (Post-Operative Care)

      The recovery process following shoulder dislocation surgery, particularly after a Bankart repair, involves several important steps to ensure proper healing:

      1. Hospital Stay:

      • Monitoring: You may need to stay at the hospital for one day following the surgery. During this time, medical staff will monitor your recovery and ensure that there are no immediate complications.

      2. Pain and Infection Management:

      • Pain Medications: Your doctor will likely prescribe pain relief medications to manage discomfort post-surgery.
      • Antibiotics: To prevent infection at the surgical site, antibiotics may be prescribed.

      3. Physiotherapy and Rehabilitation:

      • Early Rehabilitation: Physiotherapy usually starts within a week after surgery. A physiotherapist will guide you through exercises and provide home care tips.
      • Immobilization: Depending on the type of surgery, an immobilizer or sling may be worn for 4–6 weeks to help protect the shoulder during healing.

      4. Daily Activities:

      • Non-Surgical Arm: For the first 5-7 days post-surgery, avoid using the surgical arm for daily activities. Rely on the non-surgical arm as much as possible to prevent unnecessary strain on the healing shoulder.

      5. Driving:

      • Driving Restrictions: You should avoid driving for 4-6 weeks after the surgery to ensure you have regained adequate mobility and strength in the shoulder.

      6. Activity Limitations:

      • Weightlifting and Contact Sports: Refrain from lifting weights or engaging in contact sports with the surgical arm for at least six months post-surgery. This will help prevent undue stress on the healing joint.

      7. Medication Adherence:

      • Follow the Prescription: Ensure you take all prescribed medications as directed by your doctor, as they are essential for pain management and recovery.

      By following these guidelines and closely adhering to your healthcare provider’s recommendations, you can support a smooth recovery process and avoid complications.

      Complications and Risks Involved in Shoulder Dislocation Surgery

      While shoulder dislocation surgery is generally safe and effective, it does carry some potential risks and complications. These include:

      1. Nerve Injury: During surgery, there is a small risk of damaging the nerves around the shoulder, which may result in numbness, weakness, or pain in the arm or shoulder.

      2. Poor Suture Attachment: In some cases, the sutures used to repair the ligaments or tissues may not properly hold, potentially leading to instability or the failure of the surgical repair.

      3. Wound Infection: Although rare, infection can develop at the surgical site, leading to swelling, redness, or fever. Proper wound care and antibiotics are essential to reduce this risk.

      4. Rupture of Repair: There is a risk that the surgical repair might fail, especially if the shoulder is subjected to excessive stress or movement too soon after surgery.

      5. Shoulder Stiffness: After surgery, some patients may experience limited range of motion or stiffness in the shoulder, which can affect their ability to fully move the joint.

      6. Recurrence of the Injury: Shoulder dislocations may reoccur, particularly if the joint does not heal properly or if rehabilitation is not followed as prescribed.

      7. Tear of the Rotator Cuff: There is a risk of damaging the rotator cuff muscles during surgery, which could affect shoulder function and require further treatment.

      8. Long-Term Complications Due to Low-Quality Anchors: In some cases, if low-quality or improperly placed anchors are used in the surgery, it could lead to long-term complications such as instability or deterioration of the joint.

      While these risks exist, they are generally rare, and the success of the surgery largely depends on the surgeon’s experience, the type of surgery performed, and the patient’s adherence to post-operative care instructions.

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