Header: Shoulder Injuries

Shoulder Dislocation - Tendon Rupture - Acromioclavicular Joint Injury - Fracture

In recent years, we have observed an increase in shoulder injuries. Responsible are certainly also changes in recreational behavior, especially the participation in injury-intensive sports such as snowboarding or inline skating.

 

Successful treatment of shoulder injuries requires above all an accurate diagnosis. The shoulder specialist must initially assess the extent of the shoulder injury based on the sequence of events, e.g. the exact circumstances of the accident/incident, physical examination, ultrasound examination, and if necessary an X-ray or magnetic resonance (MRI). Thereafter, a targeted, efficient treatment can be initiated.

The most often occurring shoulder injuries are:

Shoulder luxation / Shoulder instability

A shoulder luxation/dislocation can result from a forceful jerking motion, or a fall onto the arm. If in such an incident stabilizing soft tissue of the shoulder such ligaments or the articular labrum overstretched and torn, the consequence is most often chronic shoulder instability. Important for the optimal treatment of a shoulder dislocation is usually a magnetic resonance imaging (MRI), which can assess the exact extent of the shoulder joint damage.

In many cases, the injured structures must be repaired surgically so that the patient can regain full function of the shoulder and is relieved of the pain. Such a surgery should be carried out minimally invasive, i.e. arthroscopically, by a shoulder specialist.

Tendon Rupture / Rotator Cuff Tear / Rotator Cuff Rupture:

A fall on the shoulder or a violent jerking motion may lead to a rotator cuff tear, meaning one or more tendons that attach to the humeral head, are partially or completely torn. A tendon rupture occurs especially when previously a wear-and-tear related damage, such as a chronic impingement, to the rotator cuff, was present.

The rotator cuff tear is always a serious impairment of shoulder mechanics that does not heal by itself, e.g. generally a surgical procedure is necessary to repair the damage.

Shoulder Contusion / Tossy Injury / Acromioclavicular Separation

A fall onto the shoulder can sometimes cause great problems with the shoulder. Especially in younger patients the acromioclavicular joint (AC joint), which connects the clavicle and the acromion bone. The severity of the injury ranges from a bruise, to a more or less pronounced overstretching or tearing of important stabilizing ligaments (Tossy grade 1 to 3, or Rockwood grade 1 to 6). The appropriate treatment depends on the extent of the injury and the activity level of the patient.

In mild and moderate injuries (Tossy grade 1 and 2) the shoulder should be immobilized; with stronger injuries (Tossy grade 3) surgery is recommended in most cases.

Bone Fracture 

A fracture of the shoulder is usually the result of a serious fall or a blow to the bone. Depending on the localization of bone fracture and the degree of displacement of the broken parts of the bone, the fracture is treated either conservative, meaning that the arm is immobilized in a sling or even a cast. Sometimes the fracture must be treated surgically. In surgical techniques, the internal splinting of fractures with intramedullary nails has in recent years become a standard procedure.

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