Orthopedic Surgery and Shoulder Traumatology

Trauma to the shoulder is common. Injuries range from a separated shoulder as a result of a fall on the shoulder to a high-speed car accident that fractures the shoulder blade (scapula) or the clavicle (clavicle).

The area of ​​Traumatology and Orthopedic Surgery includes prevention, diagnosis, surgical and non-surgical treatment and monitoring of all conditions of the musculoskeletal system and its associated structures (bones, joints, ligaments, tendons, muscles and nerves).

There are many types of shoulder injuries

  • Fractures are broken bones. Fractures commonly involve the clavicle (clavicle), the proximal humerus (upper arm bone) and the scapula (omóplato).
  • Dislocations occur when bones on opposite sides of a joint do not line up. Dislocations can affect any of three different joints.
    • A dislocation of the acromioclavicular joint (clavicle joint) is called “shoulder apart”.
    • A dislocation of the sternoclavicular joint disrupts the connection between the clavicle and the sternum (breastbone).
    • The glenohumeral joint (the ball joint of the shoulder) can be dislocated to the front (previously) or backwards (subsequently).
  • Soft tissue injuries are ligament tears, tendons, shoulder muscles and joint capsule, such as rotator cuff tears and labrum tears.

Orthopedic Surgery and Shoulder Traumatology in Bogotá

Orthopedic Surgery and Traumatology

Orthopedic surgery or orthopedics is the branch of surgery that deals with acute injuries, Chronicles, traumatic and overuse and other disorders of the musculoskeletal system. Orthopedic surgeons address most musculoskeletal conditions, including arthritis, trauma and congenital deformities, using both surgical and non-surgical means. Traumatology is the study of wounds and injuries caused by accidents or violence to a person, and surgical therapy and damage repair.

Orthopedic Surgery and Shoulder Traumatology is justified by the frequency of problems of this joint in all age groups: shoulder dislocation problems and shoulder instability in young patients; fractures at any age; and rotator cuff pathology, shoulder osteoarthritis and the need for shoulder prostheses in older ages.

Orthopedic Surgery and Shoulder Traumatology

Types of injuries

Shoulder splits
Acromioclavicular joint dislocations can be caused by falling onto the shoulder or lifting heavy objects.. The term "shoulder separation" is not really correct, because the injured joint is not actually the true shoulder joint.
Shoulder dislocations
Anterior shoulder dislocations are due to the arm being forcefully twisted outward (external rotation) when the arm is above shoulder level. These injuries can occur from many different causes, including a fall or direct blow to the shoulder.

Posterior shoulder dislocations are much less common than anterior shoulder dislocations. Posterior dislocations often occur from seizures or electrical shocks when the muscles in the front of the shoulder are contracted and tightly strained.
Fractures of the clavicle or proximal humerus can be caused by a direct blow to the area due to a fall., collision or car accident.

Because the scapula is protected by the chest and surrounding muscles, does not fracture easily. Therefore, scapula fractures are usually caused by high-energy trauma, like a high speed car accident. Scapula fractures are often associated with chest injuries.
AC dislocation
Dislocations of the joint between the clavicle and the scapula are usually the result of a direct fall on the shoulder. Usually, only in special cases of AC dislocations and in young patients with a recent injury is an indication for OP given. Through new methods of dynamic fixation, operative therapy for this injury is increasingly important.
Biceps tendon tear
In addition to the frequent injury of the long biceps tendon in the region of the shoulder joint, biceps tendon tear is often found in the elbow when an abrupt force is applied. If the injury affects the dominant side, and if the patient depends on a strong reverb function of the forearm, approximate normal function can only be restored by surgical reattachment of the tendon.
Rupture of the rotator cuff
A rotator cuff tear affects one or more tendons of the four shoulder muscles, the so-called rotator cuff. The injury can be caused by an accident or have chronic causes. Depending on the extent and age of the patient, therapy options can be infiltrations, targeted physical therapy or a surgical reconstruction of the tendon.
Shoulder osteoarthritis
When the cartilage substance in the shoulder joint disappears, it's called shoulder osteoarthritis. Movement limitations, inflammation and painful stiffness of the joint and swelling are typical symptoms of this disease. Through constant physiotherapy, deterioration can be stopped, while in the final stage a prosthesis is installed.
Shoulder girdle fractures
Fractures around the shoulder girdle most often affect the collarbone and upper arm; The so-called dislocation fractures are also associated with capsule and ligament injuries and practically always require surgical procedures with reduction of the dislocated fragments and fixation with screws and plates or nails..
Shoulder dislocation
The so-called instability of the shoulder occurs when the capsular ligament apparatus of the shoulder joint is injured due to trauma or is chronically overstretched. Depending on the degree of injury and the age of the patient, a reduction may be sufficient, or surgical treatment may be necessary to prevent restriction of movement, pain and possibly further dislocation.
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The shoulder is made up of three bones

  • Scapula (omóplato)
  • Clavicle (clavicle)
  • Humerus (arm bone)

These bones are joined by soft tissues (ligaments, tendons, muscles and joint capsule) to form a platform for the arm to function.

The shoulder is made up of three joints

  • Glenohumeral joint
  • Acromioclavicular joint
  • Sternoclavicular joint

The shoulder also has a joint, what is the relationship between the scapula (omóplato) and the chest wall.

The main joint of the shoulder is the glenohumeral joint. This joint consists of a ball (the humeral head) on a golf tee joint (the glenoid of the scapula).

The bones of the shoulder are covered by several layers of soft tissue.

  • The top layer is the deltoid muscle, a muscle just under the skin, giving the shoulder a rounded appearance. The deltoid muscle helps bring the arm overhead.
  • Directly below the deltoid muscle is the subdeltoid bursa, a fluid-filled sac, analogous to a water balloon.
Orthopedic Surgery and Shoulder Traumatology

Orthopedic Surgery and Shoulder Traumatology Bogota Medellin Colombia Cali Pereira Manizales

Our objective is to solve in an effective and early way the pathologies of the shoulder girdle, from the clavicle to the origin of the forearm, encompassing the scapulo-thoracic joints, shoulder, acromio-clavicular and elbow. These conditions can be of traumatic origin (fractures, dislocations, sprains, tendon ruptures and disjunctions); due to sports or work overload (tendinitis, muscle injuries); degenerative (osteoarthritis, chronic tendon ruptures) and neurological.

The shoulder is the part of the body that serves as a link between the arm and the body. It is formed by the union of the ends of three bones: the clavicle, the scapula (omóplato) and the humerus, besides muscles, ligaments and tendons. The main joint of the shoulder joins the head of the humerus and the scapula or shoulder blade and is called the scapulohumeral joint and has two articular surfaces (one corresponds to the head of the humerus and the other to the glenoid cavity of the shoulder blade). A) Yes, the head of the arm bone fits into a rounded socket in the shoulder blade. Both surfaces are lined with cartilage to allow smooth and painless movement. Besides, a set of muscles and tendons are attached to the surfaces of the bones and make the joint mobility possible. Among them the rotator cuff is very important, formed by four muscles that give mobility and stability to the shoulder. Is the shoulder the joint with greater range of motion of the whole body.

Frequently Asked Questions about: Orthopedic Surgery and Shoulder Traumatology

Common Questions and Answers about Shoulder Orthopedic Surgery and Traumatology

The shoulder is actually made up of a set of joints that are combined with the tendons and muscles and allow a wide range of movements in the arm and that allow us to scratch our back, swimming, escribir, using silverware or playing certain sports that require the use of arms.

Symptoms of shoulder fractures are related to the specific type of fracture.

General findings

  • Pain
  • Swelling and bruising
  • Inability to move the shoulder
  • A grinding sensation when the shoulder is moved.
  • Deformity: “Does not look good”

Specific findings: clavicle fracture

  • Swelling in the middle of the collarbone area
  • An area that may have a “package”, which are actually the prominent ends of the fracture under the skin.
  • Shoulder range of motion is limited, although not as much as with proximal humerus fractures

Specific findings: scapular fracture

  • Pain
  • Swelling
  • Severe bruising around the shoulder blade

Specific findings: shoulder parting (separation of the acromioclavicular joint)

  • Pain in the upper shoulder
  • A bump or bulge on the top of the shoulder.
  • The feeling of something stuck to the shoulder.

Specific findings: proximal humerus fracture

  • A very swollen shoulder
  • Very limited shoulder movement
  • Severe pain

Specific findings: shoulder dislocation (glenohumeral joint dislocation)

  • A prominence over the front of the shoulder.
  • Inability to move the arm
  • One arm turned out
  • The feeling of a “dead arm”

Most of the shoulder pathologies are included in 4 categories:

  • Inflammation of the tendon (bursitis or tendonitis), or tendon tear
  • Instability
  • Osteoarthritis
  • Fracture of a bone

Other less common are tumors, infections and nerve-related problems.

A) Yes, the main pathologies suffered by the shoulders are:

  • Bursitis: small fluid-filled sacs located in the joints throughout the body and shoulder as well. Sometimes overuse of the shoulder leads to inflammation or swelling of the bursa between the rotator cuff and the shoulder blade.. This swells and hurts.
  • Tendinitis: the tendon is a kind of cord that connects the muscle and bone. Most tendinitis is the result of tendon wear.. It may be acute or chronic, when it is produced by a degenerative disease. The most commonly affected are the four tendons of the rotator cuff and one of the tendons of the biceps..
  • Tendon tears: may be the result of acute injuries or degenerative changes from aging, excessive and prolonged use, wear and tear or sudden injury. They can be partial or completely tear the tendon. Rotator cuff and biceps tendon injuries are the most common.
  • Compression: occurs when the top of the shoulder blade presses on the underlying soft tissues, raising the arm away from the body. As the arm is raised the part of the shoulder blade compresses the rotator cuff tendons and the bursa. This causes pain and can cause tendonitis or bursitis.. If compression is left it can lead to a rotator cuff tear.
  • Instability: occurs when the head of the arm bone is forced out of the shoulder socket. It can occur from a sudden injury or overuse. A shoulder dislocation can be partial or complete.
  • Osteoarthritis: it is usually due to wear and tear. The symptoms (inflammation, pain and stiffness) usually start in middle age and the pain worsens over time. May be related to sports injuries, work or wear.
  • Fracture: is the breakage of some bone. They usually involve the clavicle (neck bone), humerus (arm bone) and the shoulder blade (scapula). In older patients, they are usually injuries from falls. In young people they are often caused by an injury related to traffic accidents or injuries in contact sports. Fractures cause a lot of pain and inflammation.

The main treatment for shoulder injuries usually involves repose, and change in activities and physical therapy (physiotherapy) to improve shoulder strength and flexibility. Overexertion or activities that the patient is not used to should also be avoided.. In addition to the above, the Traumatology specialist may indicate some medicine to reduce inflammation and pain, always following the specialist's indications to be effective. Finally the surgery may be necessary to resolve some injuries. However, most shoulder injuries will respond to simple treatments (change of activities, repose, moderate physical exercise or medications). If surgery is necessary, the most common are arthroscopy, to repair torn tissues, or traditional open procedures, if the reconstruction is greater.

Most clavicle fractures can be treated without surgery. Surgery is necessary when there is a compound fracture that has gone through the skin or the bone is seriously out of place. Surgery generally involves fixation of the fracture with plates and screws or rods within the bone..

Most proximal humerus fractures can be treated without surgery if the bone fragments are not displaced out of position. (displaced). If the fragments move out of position, surgery is usually required. In general, surgery involves fixation of the fracture fragments with plates, screws or dowels or involves a shoulder replacement

Most scapula fractures can be treated without surgery. Treatment involves immobilization with a shoulder sling or immobilizer, ice and pain relievers. The patient will be examined for additional injuries.

About 10% to the 20% of scapula fractures need surgery. Fractures that need surgery usually have fracture fragments involving the shoulder joint or there is an additional fracture of the clavicle. Surgery involves fixation of the fracture fragments with plates and screws.

Treatment of shoulder separations is based on the severity of the injury, as well as in the direction of separation and physical requirements of the patient.

Less serious shoulder separations) are usually treated without surgery.

Severe upward separations or backward or downward dislocations often require surgery. Surgery involves repair of the ligaments.

Professional athletes and manual workers are often treated with surgery, but the results are often unpredictable.

The initial treatment of a shoulder dislocation consists of reducing the dislocation (“put it back in the socket”). This usually involves treatment in the emergency room..

The patient is given a mild sedative and pain relievers, usually through an IV. Often, the doctor will pull on the shoulder until the joint is realigned. The reduction is confirmed on an x-ray and then the shoulder is placed in a sling or special brace.

Further treatment at a later date is based on the age of the patient, evidence of persistent shoulder misplaced problems and associated underlying soft tissue injury (either in the rotator cuff or in the capsulolabral complex).

Patients who have 25 years or younger usually require surgery. Persistent instability (repeated dislocations) shoulder usually requires surgery. Surgery involves repairing the torn soft tissues.


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Testimonials from our patients

I broke my left rotator cuff while falling. I tried to put up with it for almost a year with medications, physical therapy and basically it didn't help . I was scheduled for surgery elsewhere. I did not like the atmosphere, so I looked for another opinion. I am happy to have done it !! all nursing staff, ambulatory surgical units, postoperative care and now the final results: I have no pain I have a full range of motion, I have strength and continue to develop it while following a very detailed therapy regimen. I can only recommend Dr.. Danilo Velandia and elite staff, professional, personal, warm and friendly.

Camila cardenas Orthopedics and Traumatology Patient

I am so impressed and grateful for the care that Dr.. Danilo, that every time I get a chance to give a positive review, I can not resist! The level of care he provides far exceeds that of any other doctor I have ever seen. I am so impressed. He patiently explained every detail of the treatment plan for my broken Knee to me and really took the time to listen and answer all the questions I had.. If I ever have to refer someone I know to an orthopedic surgeon, I will insist that they see Dr.. Danilo Velandia. There is no one else I would turn to if I needed one again. Thank you Dr. Danilo for the great care you have given me!

Raul Cespedes Orthopedics and Traumatology Patient

I have seen Dr.. Danilo Velandia a couple of times in Bogotá and I'll be back, it's been great so far. No pressure to rush to surgery, great advantage. Gives good information and options from the first day to the surgery process. All staff are friendly and helpful highly qualified, He has been the most proactive and helpful medical person I have dealt with and I am really very happy. Your diligence has made sure you get the help you need, and it even helped me avoid forgetting things. Thank you very much indeed! I am very happy with my visits with him. Highly recommended Dr. Danilo Velandia and his team of professionals!

Pedro Mutis Orthopedics and Traumatology Patient

My experience as a patient of Dr.. Daniel has been extremely positive. Performed surgery on my right shoulder, completely relieving my symptoms. He patiently listened to my concerns, answered my many questions and provided insightful information, but not too technical. The doctor. Danilo made himself available both before and after my surgery to address my pre-surgery nerves and my post-surgery expectations.. He was always professional, patient and attentive. I feel very lucky that when I could no longer suffer with the symptoms, my husband, who recommended me to Dr.. Danilo Velandia.

Maria lopez Orthopedics and Traumatology Patient

After playing competitive soccer for several years, I broke my anterior cruciate ligament and meniscus. I was very nervous about the long process of surgery and recovery really is a life changing process, I thought I would lose everything since sport is my life and my passion, but Dr.. Danilo Velandia was very helpful, informative and reassuring, he really knew how to handle the situation. My surgery went smoothly and my recovery went according to plan. The doctor. Danilo was present every step of the way and showed his medical competence, as well as his natural compassion, Thank you very much and very grateful, I have been able to continue with my day to day.

Andres Perea Orthopedics and Traumatology Patient

    Traumatologist Orthopedist