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London consultant writes about new surgical treatments for shoulder injury

Richard Sinnerton, consultant orthopaedic surgeon

Specialist Mr Richard Sinnerton warns patients with shoulder injuries about the potential problems with some traditional treatments – which he labels ‘supervised neglect’. Writing for inCapitalHealth he says a significant improvement in outcome is likely thanks to a range of new surgical options.

In the last few years specialist Mr Richard Sinnerton has witnessed a sea-change in the management of shoulder trauma. Thankfully, the treatment of shoulder injuries has changed vastly for the better. Significant improvement in outcomes are now possible which means there is no longer a need for the old-fashioned sling - a treatment he refers to as ‘supervised neglect’ in an article published on inCapitalHealth.

Mr Sinnerton was prompted to write the article because he all too frequently sees patients with high-energy shoulder injuries who have been treated the old-fashioned way to their cost. One example is a broken collar-bone where the ends of the bones are completely off-ended, overlapped by more than 1 cm and with one end tenting the skin – these really do merit an operation not a pat on the head and two paracetamol.

Mr Sinnerton says the shoulder is a complex joint whose role is to position the hands in space around the body so they can perform their functions. When it works properly we don’t give it a second’s thought. It’s only when injury occurs that we realise how incapacitating a damaged shoulder can be. The operations he describes give Nature a helping hand in the early stages when the body is desperately trying to heal. Rather than replacing parts through large incisions or using materials that stay in the body for ever, new minimally invasive, arthroscopic techniques using bio-absorbable materials hold the damaged parts together while they heal.

Now, he says, the best results can be achieved with surgery. Pinning broken bones rather than using a plate and screws means a much smaller incision which is of particular importance to female patients who want their collar bones to be on display without a prominent scar. Re-attaching the tissue torn when a shoulder dislocates using the surgical equivalent of a rawl plug reduces the chances of a recurrent dislocation – for sporty under-30’s the risk is over 80%. He also describes how to deal with acute acromio-clavicular joint disruptions which all too frequently happen to mountain bikers.
 
Richard Sinnerton says: “Some sports are clearly more dangerous than others and impact sports or collision sports as our American cousins call them, carry a higher risk than lawn bowls. In this article I want to explain the ‘state-of-the-art’ options available to treat three of the most common shoulder injuries giving you all the information you need should you fall off a horse, go over the handle-bars or get up-ended and dumped unceremoniously in a rugby match and need surgery!”

Shoulder surgery news : 10/07/2009