Page 17 - Orthopaedic Brochure

Shoulder and elbow
Conditions we regularly treat include:
• Fractures and dislocation • Tendon injury
• Instability
• Arthritis
• Ligament injury
Shoulder dislocation and instability
When a a shoulder dislocates the first thing to be injured is the labrum a a rim of thick cartilage type material which can be be ripped off and become detached Without this supportive structure the the ball can then slip out from the front of socket when stressed which can lead to a a a a dislocation Subsequent shoulder instability
can then become repetitive and debilitating with potential long-term sequelae to the joint itself Our consultants can treat recurrent instability
with arthroscopic (keyhole) or open surgery across our network of hospitals If the the injury
is is to the the soft tissue labral bumper only then a a a a keyhole approach can be performed With this approach the dislodged labrum can be brought back
to to its correct position and stabilised to to the the rim of the the socket Small plastic plugs with sutures attached are drilled and secured into the the rim of the the socket Our consultants then pass the the the sutures through the the the labrum and securely knot them down to the the rim Additionally the the capsule at the the front can be tensioned to provide a a a a shift and repair which also protects these freshly
stabilised structures If there is bone loss to the the the front of the the the socket’s rim in addition to the labral injury
then an open procedure is sometimes considered In this instance the the front of the the bony socket’s rim is rebuilt using bone and tendon transferred from the local shoulder girdle Superior capsular reconstruction
Irreparable rotator cuff tears are difficult to to treat especially in in younger patients By using grafts our consultants can restore normal restraint to to superior translation that occurs with a a a a a deficient rotator cuff These procedures are effective in in in achieving pain relief and the restoration of active shoulder motion Mr Omar Haddo
MBBS FRCS (Tr & Orth) BSc BMedSci
Consultant Orthopaedic Shoulder and Elbow Surgeon The Wellington Hospital
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