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  • separation

    I separated my shoulder last saturday in a rugby match, I went to the orthopedic surgeon today at the hospital and she did not indicated what grade it was, I suspect it is a grade 3 as it has a very big lump sticking up.

    The surgeon recommended surgery as the best option, she said that most people get it done. If i dont get surgery she said that it is very likely that i will develop arthiritis in the ac joint. If i dont get surgery iu can go back to playing rugby in about three weeks she said.
    But Im not soo sure i can live with have a deformed shoulder, its very prominent, it can be seen even when im wearing a shirt.

    She said she was going to pin the ac joint down for 4 weeks i think.

    Is surgery the best option? the orthopedic has made it sound like it is, but would like to get others opinions.

    cheers

  • #2
    It does sound like a grade 3 A/C joint injury.

    The general view on A/C joint injuries at the moment is:

    Grade 1-2: Don't operate in the first instance.
    Grade 3+ (4, 5 and 6): Operate, although these are rare.
    Grade 3: Choice of surgery versus non-operative.

    First thing is to identify that you don't have a 3+ injury. These are A/C dislocations that are stuck way out of place that can't move back. They are all very rare. A grade 3 injury sits way higher than it should, but if you support the arm and relax as much as possible, you can feel the clavicle can still 'move'. The average grade 3 injury will move slightly back into place over time and the lump will be less prominent. If you have a grade 3, which is likely, over the next week you will see the lump slowly become less prominent.

    The problems you can have after a grade 3 injury has healed are:

    Chronic pain: most likely poor outcome, which can be treated by late surgery. Probably equally likely after conservative and surgical treatment, but most A/C injuries DON'T get this.
    Chronic instability: a feeling that the A/C joint is still moving around when you do high intensity activities overhead. Surgery should prevent this from happening, it is still a possibility, but rare, after conservative (non-surgical management).
    Deformity: Post surgery there would be much less lump, but instead you have a scar. Which is worse? I guess this is an individual preference.

    Bottom line is around the world I would say that 95% of grade 3 A/C joint injuries DON'T get surgery, and this is what I would advise. If you are a pro-weightlifter, or gymnast, maybe surgery might be advised. Even pro-football players generally wouldn't get surgery.
    The staff of injury update are not responsible for views of other users posted in this forum.

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    • #3
      Here is a good link:

      http://www.physsportsmed.com/issues/...01/johnson.htm
      The staff of injury update are not responsible for views of other users posted in this forum.

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      • #4
        thanks for the reply.

        The orthodpedic said that if I decide not to go with surgery then I have a very high chance of getting arthritis. She also said that most people decide to go with the surgery.

        Ultimately what I want is for the lump to go away. I am young and i dont realyl want a lump on my shoulder for the rest of my life. Scars heal to an extent.

        I just dont want surgery to make the injury worse.

        It has been nearly a week since it happened, and it doesnt feel like it is going down at all.

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        • #5
          surgery on separation

          I have decided against surgery at this stage.

          However down the track am i able to get surgery to make the lump go away. Because it is a fairly obvious lump when im wearing a singlet.


          thanks
          lawson

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