Duration of the operation
In arthroscopic surgery (minimally invasive surgery), which is usually performed, the surgery time is usually 30-45 minutes. If it is a more complicated dislocation with several concomitant injuries, the surgery time can also be longer. However, it is generally a short operation.
Advantages of the operation
In many cases, surgery is not necessary, since manual repositioning of the shoulder joint and subsequent physiotherapy are completely sufficient. Especially older people, whose sportive/physical activity is mostly limited, do not need an operation (if there are no major injuries in the shoulder area), because anesthesia is associated with higher risks in older patients than in younger patients. In addition, the healing process following surgery is more protracted, since the shoulder must not be fully loaded for a long time. After a conservative treatment, the shoulder joint should also be protected for about two weeks, but the healing process is still faster than after an invasive procedure.
Complications
Common complications after shoulder dislocation are:
- Frozen shoulder
- Fracture (Tuberculum majus tear)
- Injury to nerves (axillary nerve)
- Joint bleeding due to capsule injuryCapsule rupture
How long are you on sick leave?
After an operation, a restriction of mobility is to be expected. However, it is not possible to give a general answer to the question of how long one will be sick after a shoulder dislocation that has been treated surgically. However, at least one week is to be expected, of which two days may be required for the inpatient stay following the operation. In addition, patients may be taken ill for a longer period of time, depending on the physical strain of the job. If the non-dominant arm is affected (the left arm for right-handed people and vice versa), work can be resumed earlier, depending on the profession.
Aftercare
The operation is not performed on an outpatient basis, but as an inpatient. After the operation, patients usually remain in hospital for about two days to observe the further course of the operation. After the operation, the arm must be spared for the time being in order to avoid a renewed shoulder dislocation.
During the first six weeks after the operation, the arm may only be moved to a limited extent and a special shoulder bandage (Desault- or Gilchrist bandage) must be worn at night. Complete immobilization of the arm in the first six weeks should, however, be avoided at all costs, as otherwise the muscles and tendons will recede, resulting in joint stiffness. Targeted exercises should be carried out with a physiotherapist.
In the first six months after the operation, sports that are performed overhead or team sports with physical contact or a greater risk of injury should be avoided. Physiotherapeutic treatment is indicated both when the shoulder dislocation is treated conservatively and after surgery. Physiotherapy serves to strengthen the shoulder musculature and thus ensure that it contributes to increased stability of the shoulder joint and can prevent dislocation in the future.
The physiotherapist pays particular attention to the four muscles, the so-called rotator cuff. These ensure that the humerus is held in the joint socket. Even when the full range of motion of the shoulder has been restored, regular preventive exercises should be performed to strengthen the school muscles.
However, this does not necessarily have to be done together with a physiotherapist. The physiotherapist can show his patients exercises that they can perform alone at home in the future.
