Is An Additional Surgical Treatment Advisable Based On The X-ray Reports To Treat Frozen Shoulder?
Question: I am a 58 year old male. Type 2 insulin dependant diabetic. April 2017 fell at work fractured right humerus and dislocated right shoulder. Had ORIF and unfortunately suffered post operative radial nerve palsy to right hand.
I can now dorsal flex fingers and wrist to neutral but not beyond this. However after 9 months of physio right shoulder will only allow 90 degrees of forward flexion actively and passively, abduction is to 40 degrees actively and passively, external rotation is to 30 degrees , internal rotation is to the buttock. My surgeon tells me that there is no impingement of the shoulder and this lack of mobility is all due to my shoulder being 'frozen' and that there may or may not be further improvement and that she is not recommending any further surgery to try and ease the shoulder. I have attached two screenshots of my most recent x rays of my right shoulder. When I compare them to an x ray of a 'normal' shoulder I am surprised as how different my shoulder now looks to a 'normal' shoulder.
My question is ;-
Looking at the x rays how would you assess the surgeons work and do you agree that further surgery is not necessary.
I can now dorsal flex fingers and wrist to neutral but not beyond this. However after 9 months of physio right shoulder will only allow 90 degrees of forward flexion actively and passively, abduction is to 40 degrees actively and passively, external rotation is to 30 degrees , internal rotation is to the buttock. My surgeon tells me that there is no impingement of the shoulder and this lack of mobility is all due to my shoulder being 'frozen' and that there may or may not be further improvement and that she is not recommending any further surgery to try and ease the shoulder. I have attached two screenshots of my most recent x rays of my right shoulder. When I compare them to an x ray of a 'normal' shoulder I am surprised as how different my shoulder now looks to a 'normal' shoulder.
My question is ;-
Looking at the x rays how would you assess the surgeons work and do you agree that further surgery is not necessary.
Brief Answer:
Local steroid shots can help.
Detailed Answer:
Hello, Welcome to ‘Ask A Doctor’.
Thanks for posting your query.
I have seen the attached reports. The fixation has been done correctly and the fractured fragments are well aligned. But the smooth surface of the head of humerus is not there which is causing the restricted mobility around the shoulder joint. A CT scan will help in a better evaluation. The mobility can be increased with joint resurfacing or local steroid shots can help in decreasing the muscle stiffness and inflammation of the frozen shoulder.
I hope this answers your query.
Wishing you good health.
Take care.
Dr. Praveen Tayal, Orthopaedic Surgeon
Local steroid shots can help.
Detailed Answer:
Hello, Welcome to ‘Ask A Doctor’.
Thanks for posting your query.
I have seen the attached reports. The fixation has been done correctly and the fractured fragments are well aligned. But the smooth surface of the head of humerus is not there which is causing the restricted mobility around the shoulder joint. A CT scan will help in a better evaluation. The mobility can be increased with joint resurfacing or local steroid shots can help in decreasing the muscle stiffness and inflammation of the frozen shoulder.
I hope this answers your query.
Wishing you good health.
Take care.
Dr. Praveen Tayal, Orthopaedic Surgeon
Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar