Shoulder and Elbow Surgery

Shoulder Pain

Shoulder pain is a common problem presenting to general practitioners. The shoulder joint is prone to injury since it is very mobile. Frequent activity overhead and sudden trauma can cause damage to the tissues inside the shoulder. As well as pain, shoulder problems may present as weakness or restricted movement. The correct treatment depends on establishing the exact diagnosis. Often the diagnosis can be made on the history of symptoms, physical examination and radiological tests such as x-rays and MRI scan. Many causes of shoulder pain can be treated without surgery by steroid injection and/or physiotherapy. For more severe causes of shoulder pain such as subacromial impingement, frozen shoulder, rotator cuff tendon tear, shoulder instability/dislocation and osteoarthritis, surgery may be required. Depending on what operation is required this can either be a keyhole or open procedure

 

Shoulder Arthroscopy

Shoulder arthroscopy is a type of keyhole surgery that is used to look inside and treat damage to your shoulder caused by an injury, arthritis or certain health conditions. Shoulder arthroscopy is performed by making small cuts and placing a camera inside your shoulder, more than one cut is frequently required. 

This surgery is commonly performed to

  1. Repair the rotator cuff, which are muscle around the shoulder which help to move the shoulder and stabilise it.
  2. Treat shoulder impingement, which a major cause of shoulder pain
  3. Stabilise the shoulder, some patients with recurrent dislocation can have their stability restored with surgery

 

 

Elbow surgery

The elbow is a hinge joint that also allows rotation of the forearm. Problems with the elbow may present as pain, swelling, stiffness or a tingling sensation. Tennis elbow is inflammation of the tendons on the outer side at the elbow joint. Golfers elbow is similar inflammation on the inner side of the elbow joint. Both of these conditions can be painful for a long time and cause significant restrictions in activity. In the majority of cases, both these problems can be treated with a combination of elbow braces, physiotherapy and appropriate injection techniques. Very rarely (less than 5% of cases) is surgery required. An olecranon bursa is a swelling over the point of the elbow which can sometimes grow dramatically in size and excision may be requested. The ulnar nerve can be entrapped as it passes close to the elbow joint, and this can cause pain and tingling in the forearm and numbness in the little finger. The elbow like other joints can undergo osteoarthritic change and also be damaged by fracture or dislocation.

 

 

Hand surgery

 

The human hand is a very complex structure with many components. The components such as nerves, tendons and joints can undergo wear and tear changes as well as being injured.

Patients present to our department with a wide variety of conditions:

  • The joints in the hand can undergo arthritic change and also be associated with small cystic swellings called ganglia, these are usually painless swellings. Ganglions usually only require treatment if they are painful or cause a reduced range of movement in a nearby joint.
  • The tendons in the hand can develop painful swellings which may produce a triggering or locking phenomenon when the fingers move. Often this can be treated with a steroid injection, surgery is reserved for ongoing symptoms.
  • The median nerve which supplies sensation to the thumb, index and middle fingers can become entrapped as it passes through the wrist this is called carpal tunnel syndrome. Resulting in pain at night and numbness in these digits. This frequently requires an operation, which is very successful at curing the problem.
  • Some people may develop thickening of the connective tissue in the hand which can cause the fingers to bend into the palm especially the little and ring fingers. This is a condition known as Dupuytrens` contracture. The abnormal tissue can be remove as a day case restoring the function of the hand