Shoulder instability

The Bone Injury of the shoulder is currently the intervention that gives the best results.

This intervention is executed to prevent dislocation of the shoulder in patients with recurrent dislocation. The principle is to go fix a piece of bone (the apophysis coracoid process) at the anterior edge of the blade’s glenoid to prevent dislocation of the humeral head. The goal is to eliminate the patient’s complaint (subluxation, dislocation or even apprehension for fear that the head will dislocate).

Before the intervention: An iconographic examination including conventional X-rays but also a CT arthrography and / or scans will have be performed.

The intervention: It is performed under general or locoregional anesthesia. Usually this intervention is performed on outpatient basis (ambulatory) but if necessary you may have, in some cases, to spend a night at the clinic. The intervention consists generally to take your coracoid process, a bone block of 2 cm long in your shoulder, and put it in front of your shoulder, flush with the articulation. This bone block is fixed in front of your scapula (glenoid) by two screws. This bone block will prevent your shoulder from dislocating forward, filling the void left by the first dislocation.

After the intervention: During the after-surgery period your autonomy will be diminished. The mobility of your shoulder will be limited by a device « elbow to the body » for analgesic purpose during 15 days (to fight against pain and promote healing). You will have a checkup with radiographic control after 3 to 4 weeks and rehabilitation will be adapted to the evolution of your shoulder. It will not be possible to force on your shoulder before 45 days, time needed for a good consolidation of the graft (bone block). Restarting sports activities may take place between the second and third month after surgery depending on the sport practiced and of the evolution of your shoulder.

Expected results: The purpose of this surgery is to remove the clinical signs which are: dislocations of the shoulder, impression that the shoulder will dislocate or not move normally. Your shoulder must become stable and be used without any fear. Failure of surgery is rare with well-stabilized shoulders in more than 90% of cases. The natural evolution of your disease (tendency to a faster wear of your articulation (osteoarthritis) can not be stopped by this operation).

Summary : Stabilization of the shoulder by this technic is a common surgical procedure in orthopedics. It is a reliable intervention that must be performed by a trained surgeon. Its result will be conditioned to a rehabilitation that will last several months. The purpose of this intervention is to remove apprehension and dislocations. In most cases, this intervention allows the patient to find a stable shoulder.

During the consultation, I answer all the questions with mockups and drawings supports. A detailed information sheet will be systematically provided.

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