Dr. Melvin J. George
Orthopedician and Traumatology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
I wish to know if a surgery is needed for shoulder dislocation-cum-fracture. The patient is already undergoing treatment for arthritis and depression. So, will there be complications if put on anesthesia?
Hello,
Welcome to icliniq.com.
I understand that the dislocation has been reduced and she is planned for surgery. I need to know about the status of the fracture, whether it is displaced or not and the exact location of the fracture. Can you share with me the X-ray image, so that I can answer you to the point?
Patient's Query
Hi doctor,
I am uploading the reports. The fall happened a week ago. A dislocation reportedly was set right, but one fractured bone has broken away from the main bone and is popping out like an open book, which needs to be closed by putting a screw through surgery. I want to know if this type of surgery is required and the implications if this is not done.
Hello,
Welcome back to icliniq.com.
I went through the X-ray reports (attachment removed to protect patient identity). As they mentioned, a fragment of the bone is displaced and the chance of it healing without surgery is less. Also, the muscles, which help lift the arm, are attached there. Hence, there is a chance of the fragment moving farther. If at all it heals, the shoulder movements will be restricted I believe. So, screw fixation is well advised. They may use two screws, as from the X-ray it looks to be quite a big fragment. I hope this helps you. Please revert for any queries.
Thank you.
Patient's Query
Hi doctor.
A doctor here said surgery, though desirable, cannot be done now as the patient is having a high thyroid level (latest TSH reading is 11.4) which needs to be brought under control and may take a month or two. It is more than a week since the incident and the patient still has pain. She has been given an 'immobilizer belt' to keep her shoulder intact, but she has pain even with small movements of the shoulder (while getting up from the bed and lying down). We are worried if there is any internal injury other than a fracture, like the bone, may have got crushed into several small parts and got entrenched in the flesh. Are any such multiple fractures visible in X-ray? Will there be any danger if the surgery is not done immediately?
Hello,
Welcome back to icliniq.com.
Fracture pain will be there for two weeks which will slowly get better. It is not an emergency surgery. Watch for worsening pain or sensory disturbances along the limb. Waiting for a month may not be a good idea as the fracture will unite by that time. Endocrinologists can get it under control and she will be fit for surgery within a week, I believe. Please keep me updated.
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Orthopedician and Traumatology
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