separated shoulder surgery

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Topic Title: separated shoulder surgery
Created On: 12/01/2006 12:03 PM

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 10/23/2011 03:07 PM

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sqhill

Posts: 1


I found this blog while searching for advice on a scheduled surgery in 2 weeks for a 3rd degree separated shoulder. I crashed on my bike 2 years ago on the last training ride before a triathlon. My doctor told me I would never swim again and I would just have to live with the deformity. I proved him wrong. I'm back to triathlons and swimming better than ever. I have found a new surgeon that I trust and I've scheduled the surgery using cadaver tissue because I hate the way my "chicken wing" looks and I am unable to support my weight on my arm without it popping and sliding. If I go through with the surgery I have a few very practical questions. How long should I prepare to be out of work (I'm a school principal)? How long until I can start physical therapy? Will I be able to get clothes over my head? When can I start running again? How nasty will the scar be? Truthfully, I'm starting to panic as the time gets closer. Can you help answer my questions?
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 08/13/2011 02:00 PM

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mharasym

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I read your post and was amazed at the similarity to my case? I too am in my mid 50's, I had a bike accident 4 weeks ago, and suffered the same injuries. 3 broken ribs, collapsed lung and separated shoulder. I have a very pronounced bump at the end of my clavicle. Pain has become quite manageable, however the appearance is ghastly!

Wondering if I should pursue some sort of surgery, or will the bump settle down on its own...or just live with it.

Also, curious what the nature of your accident was? I have been riding mountain bikes for years, accident and injury free. In this case I was just riding down the street and all I can remember was my front wheel suddenly turned 90 degrees and I was launched into the air. I guess I did a flip and landed on my shoulder and upper back. A little concerned about getting my bike again until I understand what happened?

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 10/05/2010 10:09 AM

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flogger13

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I separated mine (Grade 3) 6 weeks ago, after 12 days of that pain we all know!! It was feeling better. After a few visits to the hospital. I was offered the Opp by the surgeon and advised of the complications. After much research, and if I'm honest the thought of that lump on my shoulder forever. I decided to go for the operation (Weaver Dunn), Was done 4 weeks ago today. Recovery was going fine until this week at PT, I informed them that i was getting pins and needles in my little finger and my ring finger and that I had shooting pains at my shoulder and neck. I was given some tests and some new exercises to do. I was told I have some sort of nerve damage/ trapped nerve. and that I need to go to the doctors and get some Amitriptyline. I don't like taking painkillers and have taken the minimum (When waking at night) amount throughout the recovery. I checked them out and don't really want to go down this road. http://emedicine.medscape.com/article/1244885-overview http://www.google.co.uk/search?clien...Apm8jAeVz_zJBw On returning home I researched and found that the nerve in question is the Ulnar Nerve, (from your shoulder around your elbow to your wrist then fingers) And that I may have ulnar nerve entrapment. I was sure this was a consequence of the Opp. (Bugger) After some more digging I found that this could have happened Because the elbow was immobilised for a length of time. I was not told this by the surgeon or the PT that visited me after the Opp?? Can't seem to find any similar experiences, Yet I feel this information should be out there. I am hoping to get an appointment the next few days or next week to discus the matter with the surgeon.. I would say "be careful of the amount of time you immobilise your elbow wouldn't want this to happen to anybody else.....Ask your doc about it". Hopefully if its not degenerative, I can sort this with good PT..... Really Not looking forward to another Opp Les T Morris Age 43
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 08/20/2009 12:40 PM

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MIKEPOWERSPORTS

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I had a serious grade 3 in May. The doctor they sent me to said "live with it" Plus he says " things happen and you just have to change your lifestyle".. Holy cow i was floored. I lived with it for two months then asked my GP for help. He hooked me up with a shoulder specialist, who happens to be known as a great doctor and recommended by my Triathlon trainer. The new Doc says it should have bee done within 3 weeks of injury, now it becomes more involved. So on September 1 I get screws, cadaver ligaments, and heavy duty sutures to hold it all together. It should work fine but I could have been healed by now. As it is, I will loose 6 months to this injury and to a doctor that was or is not at the top of his game.
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 07/13/2009 08:43 AM

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Impatient1

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Hi Rossevans77,I did not have the kind of surgery you asked about, but I did see a shoulder specialist at the Hospital for Special Surgery in NYC. His name is Russell Warren, very easy to talk to and has been doing surgery for a long time. I had a lot of confidence in him and had a very difficult surgery, a lattismus dorsi transfer.Karen
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 07/12/2009 09:52 AM

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rossevans77

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I have an injury similar to yours. Will you tell me the name of the Dr at HSS in NYC and what procedure they used.Thank you.
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 07/11/2009 10:32 PM

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rossevans77

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Hi, I have an injury similar to yours and I was wondering if You could refer the dr at new york HSS. I also wanted to ask you what procedure they used to get rid of the bump and raise the shoulder? thanks,
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 01/23/2007 04:59 AM

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gak

Posts: 5

Hi vkarlo, i dont know if you use this forum still, but i would be interested in exchanging some photos with you and discussing my injuries. you seem like you have some knowledge about these AC joint injuries. do you have an email address?
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 12/11/2006 03:30 PM

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vkarlo

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Yes, my clavicle was cut off a bit (5-6 mm). From what I read they do not cut more than 10-12 mm.My understanding is they do it to prevent excessive tearing when clavicle goes out of socket.Technically since AC ligament is not there anymore clavicle end motion in horizontal plane is less restricted. Even limited in verticalal plane motion it is not the same as original connection. CC ligament was of TWO "ropes" with some gap on coracoid. It was as triangle or even trapezoid. Now it is ONE "rope". Think about two and one rope "swing" from your childhood. Which one was more wild and fun:-)So clavicle is more "wild" now and in some positions it would press against acromion without shortening.Seems my injured side has a bit wider ROM now. I may not paid attention to that before injury, but remeber someone on this forum mentioned the same.My injured shoulder looks a bit diff after surgery. Mostly because of deltoid muscles shape.I attribute it to the fact that it was disturbed (moved aside) in order to reach coracoid. After 1 year it got more in shape, but there is still some "gap" comparing to other side.At the same time trapezoid muscles on injured side looks a bit more developed (though it is NOT my dominant side as well).I do not think even 12 mm shortage would cause visible litteral shortage in your shoulder.I would speculate that first of all it is our "scrutinity" how injured side looks and functions.I know definetly I did NOT pay so much attention to it before injury.Another possibility is that we unintentionaly try to "unload" that side, so it gets less load (and development).I always had my dominant (and healthy) shoulder a bit lower (from habit to carry heavy school bag).Now it is LESS noticable. I think after surgery the shoulder still remained a bit drooping. In my case it kind "fixed" my appearance, but may be in your case did the opposite.The combination of these could creat your impression. The major I think is our "paranoidy" though:-)You can email me the pics and I will reply with mine.For some time I am thinking even to set a web site and place images there (NO faces).It is definitely lack of visual info on that - I saw NONE though there are hundreds articles on AC on Web.My impression reading this forum is that for many it could be helpful and calming.I made mine just a day before surgery. Wanted to keep on the progress, but did not bother after surgery.Just curious if people reading this did it and would agree to share their pictures?
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 12/08/2006 09:58 AM

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nevets

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VkarloThanks for responding. Yes, my second surgery did involve repositioning the oracoid-acromion ligament to the clavicle. Did your surgery involve cutting off a bit of the distal end of your clavicle? This was done during my first surgery, and I asked the doctor beforehand whether it would result in a shortening of the shoulder (it seemed to me that the clavicle is kind of a strut or a boom that holds the shoulder out, and if shortened everything would move in towards the centerline). He said it would not happen, that the many muscles are actually responsible for keeping things in proper position. Well you know what...I was right. My left shoulder did get a bit shorter than my right shoulder...even accounting for the difference in development of the dominant side. I’ll take a pic of the shoulder and figure out a way to send it to you (PM I assume).
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 12/07/2006 09:57 AM

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vkarlo

Posts: 26

Your first doc was a crook.The RECONNECTION should be done within 3 WEEKS while injury is fresh.The scar should form on reconnected ligament, because after three months they are already healed.I also was offered this type of surgery after 3 months, but my gut feeling and some reading made me to look for RECONSTRUCTION.I am glad I did it a bit more than 1 year ago. Your msg just proves that I made the right choice.In general from my current experience I would agree with doctors who recommend waiting 3-6 month and then go for Weaver-Dunn reconstruction rather than reconnect it right away.By your description seems that you had coracoid-acromion ligament repositioned to clavicle.Sometimes it could be part of Weaver-Dunn along with additional piece of tissue (hamstring).However it could be separate surgery and as I read performed through small insision.I am not sure if they did it 5 years ago, but your second doc could opt for it because you already had a big scar from first surgery. This procedure is also done on chronic AC separation.I did not have CA repositioned - only hamstring was used to recreate coracoid-clavical ligament via 4 in insision.I would not mind to swap the images. I am 46.
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 12/01/2006 12:03 PM

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nevets

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HiI'm new to this forum. I'm a fairly active guy in his mid 50's. I've been reading posts about separated shoulders and surgery, and I thought I would relate my experience. 8 years ago I suffered a grade 3+ separation in a bicycle accident. I also broke ribs 1, 2, and 3, plus collapsed a lung. Pretty nasty. After about 3 months there was little pain, I regained full range of motion and most of my strength. However the deformity really bothering me...major bump and a dropped shoulder...not very sexy. I opted for the surgery with a local orthopedic surgeon. He used a long screw through my clavicle into the corocoid process to bring everything into alignment, and "string" to hold it all together. He said once it scars up it will be solid. After 6 weeks of hell (I had to sleep in a chair) he removed the screw and it was like I never had the surgery. No improvement, except now I had a scar. I then went to the Hospital for Special Surgery in NYC and consulted with a shoulder specialist. I had a second surgery in which the surgeon relocated a ligament and attached it to the clavicle (They were going to graft a bit of my hamstring, but when the good doctor got inside my shoulder, he determined that is was no necessary). My post-op pain was minimal and I soon regained strength and range of motion. It's now over 5 years since I had the surgery and all's well. No pain. I ride my bike, paddle my kayak, skip rope, do push-ups, etc. As for the appearance, well it's not perfect...it's a little lumpy, but overall I'm pretty satisfied. My advice to anyone contemplating surgery is to only go with a well-respected shoulder specialist who has performed this procedure with a high level of success. It’s a tricky operation, and most to the doctors try to avoid it because the success rate is generally not high. If anybody is interested, I would be willing to provide/swap shoulder pictures to see what the surgery result looks like.
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