Shoulder is the most flexible joint in your body. It allows you to place and rotate your arm in many positions in front, above, to the side, and behind your body. This flexibility also makes your shoulder susceptible to instability and injury.
Depending on the nature of the problem, nonsurgical methods of treatment often are recommended before surgery. However, in some instances, delaying the surgical repair of a shoulder can increase the likelihood that the problem will be more difficult to treat later. Early, correct diagnosis and treatment of shoulder problems can make a significant difference in the long run.
Types of Shoulder Problems
Bursitis or Tendinitis : Bursitis and tendinitis are conditions that are also known as soft tissue rheumatic syndromes. A syndrome is a group of signs and symptoms that occur together and indicate a particular problem. This type of syndrome produces pain, swelling, or inflammation in the tissues and structures around a joint, such as the tendons, ligaments, bursae, and muscles.
Impingement and Partial Rotator Cuff Tears : Partial thickness rotator cuff tears can be associated with chronic inflammation and the development of spurs on the underside of the acromion or the acromioclavicular joint. The conservative nonsurgical treatment is modification of activity, light exercise, and, occasionally, a cortisone injection.
Instability : Shoulder instability is a problem that occurs when the structures that surround the shoulder joint do not work to keep the ball tightly within its socket. If the joint is too loose, is may slide partially out of place, a condition called shoulder subluxation. If the joint comes completely out of place, this is called a shoulder dislocation.
Fractured Head of the Humerus (Arm Bone), or Proximal Humerus Fracture : Fractured Head of the Arm Bone occurs particularly to old people with osteoporosis as a result of falling on outstretched arms. Surgical repair is often needed when it is fractured or displaced. Often replacement with an artificial joint or prosthesis is required.
Fractured Collarbone and Acromioclavicular Joint Separation : A fractured collarbone and acromioclavicular separation are common injuries of children and others who fall on the side of their shoulder when playing. Most of these injuries are treated nonsurgically with slings or splints. Severe displaced fractures or acromioclavicular joint separation may require surgical repair.
The procedure and technique used in shoulder surgery varies depending on the specific surgery. Shoulder surgery is generally performed using one of the following approaches:
Minimally Invasive Surgery is performed by inserting special instruments and an arthroscope through small incisions in your shoulder. This approach is also known as arthroscopy. An arthroscope is a thin, lighted instrument with a small camera. The camera transmits pictures of the inside of your body to a video screen viewed by your surgeon as he or she performs the surgery. Minimally invasive surgery generally involves a faster recovery, less pain, and less risk of complications than open surgery. This is because it causes less damage to tissues and organs. Your surgeonwill make small incisions instead of a larger one used in open surgery. He or she can then thread surgical tools around structures and organs instead of cutting through or displacing them as in open surgery.
Mini-Open Surgery uses newer technology and combines minimally invasive arthroscopic techniques with a smaller open procedure. The incision is one to two inches long, which is smaller than a standard open surgery incision. This technique may allow some surgeons to make more extensive repairs than are possible with minimally invasive surgery. However, it causes less damage than traditional open surgery because your muscles remain attached during the surgery.
Open Surgery : Open surgery may be necessary and, in some cases, may be associated with better results than arthroscopy. Open surgery often can be done through small incisions of just a few inches. Recovery and rehabilitation is related to the type of surgery performed inside the shoulder, rather than whether there was an arthroscopic or open surgical procedure.
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