Dislocated shoulder- anyone had surgery?

[centerpunch]

I dislocated the right shoulder on my 54 year old body last saturday, ouch! (I was walking the dog in the wood, tripped, fell forward, and shoulder dislocated as I tried to catch my fall.)

Been to sports med specialist docs, had x-rays and MRIs, seeing shoulder surgery specialist this morning.

Googled around, it looks like pretty certain that once you dislocate it once, it's much more likely to happen again.

I think I'd go crazy if I have to constantly wonder if my arm is going to snap out- so I'm probably going to do the surgery.

Any other thoughts, expert opinions, or personal experiences?

P.S. For any docs viewing, here are the ugly details from the MRI:

1) Nondisplaced Hill-Sachs fracture of the humeral head. Bony GLAD-type anteroinferior labral tear. The findings are consistent with anterior dislocation-relocation injury.
2) Chronic degenerative labral tear from anterosuperior to posteroinferior.
3) Moderate joint effusion.
4) Mild hypertropic tendinopathy of the biceps long head tendon.
5) Myofascial edema along the scapula extending medially beyond the field of view, if medial scalpular fracture is a possibility, consider CT.

 

[Neilda]

Atomic is your man - he'll have a view (being a surgeon an' all).

I dislocated mine in my 20's, so feel your pain..... I've not had any problems with it since.

 

[AtomicGT]

Centerpunch

A complex injury to give you yes and no answers. If you are under 20 and you dislocate your shoulder, 100% chance it will happen again. Under 30 incidence goes down, under 40 1st time dislocation, probably less than 50% redislocaiton rate. In your 50s you are looking at even less redislocation rate. The Hill-Sachs lesion is the back part of the humeral head as it impacts the front part of the cup with the original dislocation. If it is a big lesion, increased chance of dislocation. Not to big, then less chance. Labral tear is like a knee meniscus, surrounds the rim of the glenoid or socket. I think with your MR results, if you push hard you will find someone to operate on your shoulder. A general orthopaedist would treat you conservatively, an agressive sports medicine doctor would operate. Most of my colleagues, not sports medicine but Ortho Trauma guys, would probably treat it conservatively and see how you do. You can always operate on this later if it becomes a problem, unlikely you would dislocate again, unless you fell on an outstretched hand, or were trying to escape out a bedroom window when a jealous husband caught you at the wrong moment!

Hold off on the CT. Give your self 6 weeks of recovery, get a good orthopaedist and anticipate a good result. The MR results are what one would expect for a shoulder dislocation. The chronic labral tearing may be related to other shoulder injury in the past or your specific kind of work through your lifetime. There is no urgency for any surgical procedure at this point in time. PM me if you want a referral in the area you live in. I have a lot of colleagues around the country.

:thumbsup

Neilda is my PR man in London! He works out of the Ye Grapes Pub, Shepherd's Market, Mayfair, a good man! Sort of a James Bond type, with more resources! :thumbsup

 

[S592R]

I had a similar injury about 20 years ago. I elected NOT to have surgery and chose to do physical therapy. Overall, I feel that I made the right choice but have noticed that when I am less than diligent about working out my shoulder tends to ache more. However, when I am diligent about working out it does not bother me at all and I have no other issues.

It comes down to the extent of the injury and your commitment to maintaining what you rebuild. IMHO.

for the record: I am NOT a doctor and I did NOT stay at a Holiday Inn express last night. :wink

 

[HHGT]

Atomic is your man - he'll have a view (being a surgeon an' all).

I dislocated mine in my 20's, so feel your pain..... I've not had any problems with it since.

Neilda, If you dislocated your shoulder in the 1920's, how young of a man are you?:lol:lol:lol

Hope you get better soon Centerpunch.

 

[Neilda]

Yes, was working with Chaplin and Keaton, stunt went a bit wrong.

'My' 20's, not 'the' 20's.... :lol

:cheers

 

[doogie48084]

I, too, dislocated my shoulder when I was much much younger. I was 16. I fell out of a pickup truck as it stopped abruptly. I have since thrown it out 2 times. I went to a sports therapy facility and they made my shoulder feel better than it has felt in many many years. I would give the muscles a chance to do their job. Weak muscles are the major cause of most of our injuries as we get older. I know I don't excercise like I should. The las time I threw it out by heaving a brick at a car that had just driven into my backyard and was trying to drive back out through another section of fence. I got his windshield and immediately fell to my knees in excruciating pain. I was proud that I got him. It was because of the windshield that he got caught. The police found him in a complex trying to get someone to drive him home. He was totally trashed.
My brother threw his out while on board a cruise ship and had to be medi-vacced to Florida for surgery. he was playing volleyball with the young kids. He was 53 at the time.

 

[Kirby Vieira]

IMO any major surgery should always be the last option. I dislocated a shoulder and did some serious disc injury in my 30's. The shoulder poped out a few times which made me smarter about protecting it. The disc was a much slower recovery process. No problems in 20+ years, during which time both have been involuntary "tested" many times. :cheers

 

[05redrich]

Dislocated my shoulder while I was in college and like you read / guessed did it a bunch of times after as a result (this would have been around 1995). Got surgery within the year, and it was a brutal surgery at that time; 3 inch scar permanent staple into the bone, etc. I am sure that times have changed and surgery has advanced, but I would say you have to be able to dedicate the next 9 months after to physical therapy as a full time job. If not you will lose range of motion.
I have had ACL surgery as well, and after that they want you up and walking on it ASAP. With my shoulder it needed to be immobilized for 4 weeks (NO MOVEMENT)! The shoulder has the most range of motion of any joint in the body, and there is not a lot holding it in place (unlike the knee). So they end up cutting and tightening everything up. These all need to heal before you move. My first day of PT 4 weeks later was just working on straightening my arm and doing maybe 2% range of motion.
I never dislocated my shoulder again, but I don’t have the range or confidence that I had prior to 1995.
I would make sure that you have the time and commitment prior to jumping into this.
Just my 2 cents (and again things may have changed a bit)

 

[Neilda]

The las time I threw it out by heaving a brick at a car that had just driven into my backyard and was trying to drive back out through another section of fence. I got his windshield and immediately fell to my knees in excruciating pain. I was proud that I got him.

I can soooo associate with this story! :cheers

 

[centerpunch]

If you are under 20 and you dislocate your shoulder, 100% chance it will happen again. Under 30 incidence goes down, under 40 1st time dislocation, probably less than 50% redislocaiton rate. In your 50s you are looking at even less redislocation rate.

Is that due to physiology, or due to the fact that statistically as you get older, you do less physically and the reduced physical behavior drives the reduced chance for another relocation?

 

[fjpikul]

Punch, as a non-forensics pathologist, the description of the films indicates to me that your wife is drugging you at night and then beating the **it out of you while you sleep. You need a nanny cam to record this at night. Let me get this clear, you fractured your humerus, too? I would think you need to be immobilized in a cast and that would certainly help your shoulder heal over. Don't look forward to that rotator cuff injury. Sit on it and see what happens.

 

[centerpunch]

My non-expert understanding is that a "Hill-Sachs fracture" is essentially a dent on the end of the humerous bone from it crashing into another bone during the dislocation event.

I wouldn't mind getting a nanny cam, but I'd rather use it to take videos of nannies, preferably young, attractive, naked, etc.

 

[nota4re]

Is that due to physiology, or due to the fact that statistically as you get older, you do less physically and the reduced physical behavior drives the reduced chance for another relocation?

Hey 'punch,

Regardless of the answer, don't fret too much. You're almost in the bonus years (what my daughter told ME a few weeks ago), and there's a Rascal model for everyone - that will lessen the possibilities of falling on your shoulder again. :rofl

 

[S592R]

I can soooo associate with this story! :cheers

People drive through your yard much? :wink

 

[Piccola]

Centerpunch-

How active are you? Everyone is different, but here is my experience...

I had left shoulder surgery in '01 following a stupid skydiving incident. It was more than a dislocation as my arm got caught in the lines on opening and was pretty much ripped out. However, I allowed myself adequate recovery, took a year off of the sport, and was diligent about doing shoulder strengthening and flexibility exercises. There is barely a scar, which is amazing considering how it looked after the accident, and for a "normal" person, I would say functionality has returned 100%.

In '05 while doing intense 4-way training (very strenuous on the shoulder in unstable positions), I kept re-injuring a labral tear that was getting worse on the right shoulder. I tried conservative treatment, but couldn't train at a high level and occasionally I wasn't able to open my parachute. Impatience and lack of recovery time had to do with it I'm sure. I had surgery on the right side this time, and I gave myself plenty of recovery and PT to get it as strong as possible.

It's now '09. I still have a LOT of problems with both shoulders. The pins are keeping both sides from dislocating, but there is a lot of movement that causes nerve and muscle problems, which can last for days. I'm not able to jump anymore, I can't throw a baseball or football as hard as I used to due to sharp pain from the snap, I can't rock climb anymore, weight lifting is severely restricted despite continuing to do shoulder exercises and strengthening on a regular basis, and many other activities I used to enjoy are limited.

I'm sharing this with you, because I had erroneously thought that surgery would make everything better. Whatever you decide to do, I wish you the best!

 

[Neilda]

People drive through your yard much? :wink

They don't - but I could imagine getting so mad that I'd throw something in anger doing more damage to me than the perpetrator. :biggrin

 

[S592R]

They don't - but I could imagine getting so mad that I'd throw something in anger doing more damage to me than the perpetrator. :biggrin

That's why you buy high rate of fire automatic weapons. May I suggest ...

 

[S592R]

yes thats a man pack gatling gun. :biggrin

 

[THamonGT]

Punch, Now that you are getting into "Your Bonus Years" you might nit fall on your shoulder again but you can fall on your ass easily. I slipped off a latter this week flat on my ass. I couldn't help but wonder how Boney would have covered this Post with wonderful comments, I'll Bet. Damn I miss him. God Bless Boney and America. Tomy