Shoulder dislocation surgery
Surgical therapy of shoulder dislocation
As part of the Treatment principles of shoulder dislocation was already between the conservative and the operational Therapy delineated. Since there is no standardized procedure that can be generally applied, only the most common surgical therapeutic measures will be addressed below. Your doctor can decide on an individual basis which surgical measure is the best for you.
General criteria for an operation
- Classification of Shoulder dislocation
- Are there any previous damage? bone-, cartilage- and Soft tissue lesions?
- Assess pain
- To what extent is there a functional restriction (effects on: mobility, strength (dead arm sign))
- Is there a feeling of instability?
- Can neurological failures, Circulatory disorders prove?
- Which sporting activities are practiced? (This question is particularly important with regard to the therapeutic measures; see below)
- Which shoulder stressful activities are carried out (professional / private)?
Common surgical procedures
At this point, not all surgical therapeutic measures for shoulder dislocation can be named and described, as there are too many surgical procedures. At this point, the most common and proven operations are named and briefly described. Depending on the etiology, type and direction of dislocation and the extent of intra-articular damage of the shoulder dislocation, the different techniques can possibly even be combined with one another. Trust your doctor in charge of this. He sees the extent of your illness and can advise you individually on this. As part of the surgical therapy, both open and arthroscopic techniques applied. Furthermore, anatomical and non-anatomical reconstruction methods are available.
1. Arthroscopic surgical techniques:
- Operation according to Neer,
- Labrum - capsule - refixation
- Open surgical techniques
- Bankart surgery (anatomical open surgical technique)
- Operation according to Neer (anatomical open surgical technique)
2. Other surgical procedures are:
- Eden - Long Hybinette (non-anatomical open surgical technique)
- Putti - flat
- Operation according to Bristow - Hilfert
- Operation according to Mayer - Burgdorff
- Operation according to Weber (non-anatomical open surgical technique)
Possible consequences and complications:
- General risks: bleeding, hematoma, impaired wound healing, infection, thrombosis, pulmonary embolism, damage to blood vessels and nerves
- Special consequences: restriction of movement (especially rotation), arthrosis (Late consequence)
- Complications: Relapse, delay in bone healing, pseudarthrosis, implant complications (incorrect position, material breakage, loosening, allergy)
Appointment with a shoulder specialist
I would be happy to advise you!
Who am I?
My name is Carmen Heinz. I am a specialist in orthopedics and trauma surgery in the specialist team of Dr. Gumpert.
The shoulder joint is one of the most complicated joints in the human body.
The treatment of the shoulder (rotator cuff, impingement syndrome, calcified shoulder (tendinosis calcarea, biceps tendon, etc.) therefore requires a lot of experience.
I treat a wide variety of shoulder diseases in a conservative way.
The aim of any therapy is treatment with full recovery without surgery.
Which therapy achieves the best results in the long term can only be determined after looking at all of the information (Examination, X-ray, ultrasound, MRI, etc.) be assessed.
You can find me in:
- Lumedis - your orthopedic surgeon
60311 Frankfurt am Main
Directly to the online appointment arrangement
Unfortunately, it is currently only possible to make an appointment with private health insurers. I hope for your understanding!
You can find more information about myself at Carmen Heinz.
Duration of the operation
In arthroscopic surgery (minimally invasive surgery), which is usually carried out, the operation time is usually 30-45 minutes. If it is a more complicated dislocation with several accompanying injuries, the operation time can be longer. However, it is generally a short operation.
Advantages of the operation
The advantage of surgical treatment of a shoulder dislocation is that new dislocations are less frequent. In contrast to conservative restoration, an operation ensures greater stability in the joint. Although an operation is associated with a longer period of rest, the problem should usually be permanently resolved afterwards. This is particularly attractive for young and physically active people. In the case of conservative care, however, the majority of those under 30 years of age experience a renewed dislocation and the instability of the joint increases with each dislocation. In the case of an operation, however, the risk of recurrence (re-luxating the shoulder) is very low. However, shoulder dislocation does not have to be operated on immediately in all cases. Often it is also a harmless joint dislocation that can be treated conservatively. However, if cartilage structures, bones or the like in the shoulder joint are additionally injured, surgery should definitely be carried out in order to restore these structures and avoid consequential damage. In most cases, an operation for a shoulder dislocation can be carried out as part of a minimally invasive procedure (joint endoscopy) with only three small skin incisions, with hardly any side effects / complications.
Disadvantages of the operation
In many cases, surgery is not necessary, as manual repositioning of the shoulder joint and subsequent physiotherapy are completely sufficient. Especially in older people, whose sporting / physical activity is mostly limited, surgery is avoided (if there are no major injuries in the shoulder area), since anesthesia is associated with higher risks in older patients than in younger patients. In addition, the healing process is more protracted after an operation, as the shoulder must not be fully loaded for a long time. After conservative treatment, the shoulder joint should be spared for about two weeks, but the healing process is faster than after an invasive procedure.
Common complications after shoulder dislocation are:
- Frozen shoulder (frozen shoulder)
- Broken bone (Greater tuberosity avulsion)
- Injury to nerves (Axillary nerve)
- Joint bleeding through Capsule injury / rupture
You can find further information on the topic of frozen shoulder under our topic: Frozen shoulder.
How long are you on sick leave?
Restriction of mobility is to be expected after an operation. However, there is no general answer to how long you will be on sick leave after an operatively treated shoulder dislocation. At least one week is to be expected, of which two days are required for the inpatient stay after the operation. In addition, patients can be written off sick longer, depending on the physical workload. If the non-dominant arm is affected (the left arm for right-handers and vice versa), work can be resumed earlier, depending on the job.
The operation does not take place on an outpatient basis, but on an inpatient basis. After the operation, the patients usually remain in the hospital for about two days to observe the further course. After the operation, the arm must first be spared in order to avoid a new shoulder dislocation. The arm may only be moved to a limited extent in the first six weeks after the operation and a special shoulder bandage (Desault or Gilchrist bandage) must be worn at night. A complete immobilization of the arm in the first six weeks should be avoided at all costs, otherwise the muscles and tendons will regress, which can result in joint stiffening. Targeted exercises should be done with a physical therapist. In the first six months after the operation, sports that are performed overhead or team sports with physical contact or a higher risk of injury should be avoided.
Physiotherapeutic treatment is indicated both when the shoulder dislocation is treated conservatively and after an operation. Physiotherapy serves to strengthen the shoulder muscles and thus ensure that they contribute to increased stability of the shoulder joint and prevent future dislocation. The physiotherapist pays particular attention to the four muscles, the so-called rotator cuff. These ensure that the humerus is held in the socket. Even when the shoulder's full range of motion has been restored, regular preventative exercises to strengthen the school muscles should be performed. However, this does not necessarily have to be done together with a physiotherapist. The physiotherapist can show his patients exercises that he can do alone at home in the future.