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).
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.
Acromioclavicular joint dislocations can be caused by falling onto the shoulder or lifting heavy objects.. The term “shoulder parting” not really correct, because the injured joint is not actually the true shoulder joint.
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.
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.
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.
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.
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.
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..
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.
These bones are joined by soft tissues (ligaments, tendons, muscles and joint capsule) to form a platform for the arm to function.
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. What's more, 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.
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, to write, using silverware or playing certain sports that require the use of arms.
Symptoms of shoulder fractures are related to the specific type of fracture.
Most of the shoulder pathologies are included in 4 categories:
Other less common are tumors, infections and nerve-related problems.
A) Yes, the main pathologies suffered by the shoulders are:
The main treatment for shoulder injuries usually involves repose, a change in activities Y 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. Nevertheless, 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% al 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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Orthopedist and Traumatologist
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