Therapy of a torn ligament in the shoulder

The ligament injuries according to Tossy I and II can be treated conservatively, i.e. without surgery. The treatment includes a six-week immobilization of the joint with a Gilchrist bandage. The immobilization reduces the tension on the joint caused by the body’s weight.

This allows the ligament structures to adapt and heal completely on their own. To alleviate the pain, an additional painkiller can be prescribed. Physiotherapy can support the healing process and avoids the development of contractures.

Minor injuries such as overstretching or strains of the ligament structures of the shoulder can be treated with kinesio tapes. With the correct application technique, the tape has a supporting and stabilizing effect on the acromioclavicular joint. The tapes are often applied in the shoulder area along the longitudinal course of the deltoid muscle.

The tape is split in the middle for this purpose. The lower continuous part is attached to the lower end of the deltoid muscle. Now one half of the tape is stuck along the front edge of the muscle, the other half along the rear edge.

Finally, the tape encloses the muscle. This relieves the injured ligament structures or supports them during movement. After a longer period of rest, the ligaments can also be applied for protection when resuming sports activities.

Injuries according to Tossy III or the types 3, 5 and 6 according to Rockwood have to be treated surgically in the first 12 days due to their instability. There is an indication for surgery, especially for younger patients with stress in everyday life and at work. In addition, the protruding collarbone is felt to be disturbing and should be reduced.

In the meantime, operations on the shoulder joint are performed arthroscopically. An endoscope is inserted through a longitudinal incision of about 3 cm above the acromion, which makes the inside of the joint visible to the surgeon. Finally, the clavicle can be reattached using appropriate instruments.

Depending on the surgical method, wires, screws or artificial bands are available to fix the clavicle to the cortex. The anatomical structures are thus returned to their original position and the shoulder joint is stable again after healing. This minimally invasive procedure takes about 2 hours or longer, depending on the severity of the injury.

If a shoulder joint replacement has been inadequately treated, chronic instability can develop in the shoulder joint. This complication can also be treated surgically by using a tendon transplant made from the patient’s own body material. Tendons from the knee flexor area such as the semitendinosus tendon are used for this purpose.

The transplant is placed through a drilled hole between the coracoid process and the bowl bone. The body’s own tissue replaces the previously unstable connecting ligament. Often this operation leads to a significantly better securing of the acromioclavicular joint and the load can be increased again.