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Suggest treatment for shoulder fracture

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Answered by

Orthopaedic Surgeon, Joint Replacement
Practicing since : 1997
Answered : 1619 Questions
Question
Hi,

My father has shoulder fracture. First doctor did plaster which cover his shoulder till his elbow. After a month he said shoulder bones seems to be joined a little and situation seems to be fine. and advised us to go for 1 more month plaster. This time he didn't cover his shoulder. My first doubt is if he has shoulder fracture, to support his broken bone of shoulder every time plaster should cover his shoulder also or not ? Since first time plaster was suporting his shoulder also, but second time he did plaster only below shoulder till elbow. And now today when we went he say bone is still not joint, though he commented calcium is enough and proper. But bones are not getting joint, so we have to go for surgery.
Can you please suggest me is it really necessary now to go for surgery. or he should have told us in second time itself that now we need to go for surgery.


One more thing to add Dr. My father has undergone heart surgery and has two stunts in his heart in year 2009. and because of that few of the Doctors told him earlier that you can not undergo any surgery further.
and because of that we do not want to take risk of shoulder surgery. because this is specially in left hand, which is close to heart too. Can you please suggest us the best remedy if we don't want to take surgery risk for my father shoulder bone. What best treatment can be given to him. We are fine even if it take longer time.

Thanks

XXXX
Posted Thu, 14 Aug 2014 in Bones, Muscles and Joints
 
 
Answered by Dr. Mukesh Chugh 10 hours later
Brief Answer:
Please send the x-ray picture

Detailed Answer:
Hello
Thanks for posting
I have gone through your query and understand your concern. You may please send the x-ray picture to say any further regarding fracture healing and other point as raised by you.
I do not have any doctor name in the region but you may visit the nearest Apollo hospital as they have all the facilities to take care of such patient if they require surgery.
Looking forward to your reply.
Take care
Above answer was peer-reviewed by
 
Follow-up: Suggest treatment for shoulder fracture 6 hours later
Hello Dr. XXXXXXX

Please reply to my above Question and I am asking one more follow-up query. If we don't plan for further surgery because of associated heart risk, in that case if we leave his left hand just like that :
1) Should we cover his shoulder with patti (red color one which was used in his second plaster
2) or can we leave his shoulder open without any cover
3) if we leave his left hand just like that without undergoing any surgery, will there be any problem which might arise later
4) would this shoulder bone join automatically eventually to shoulder mass ?
5) What would be the last impact of keeping his left hand just like that

Thanks
XXXX
 
 
Answered by Dr. Mukesh Chugh 1 hour later
Brief Answer:
Heart becomes healthy after stenting

Detailed Answer:
Hello
It’s good to see you
I have gone through the x-ray (latest?) and the fracture has not healed. First of all let me assure you that by having heart surgery do not make a person unfit for any future surgery. On the contrary his heart is more fit and has rich blood supply. Hence, it’s a sincere advise visit a nearby hospital and let the surgeon and anaesthetist decide what is best for him and please do not have false assumption by listening to non medico person’s.
You may keep the limb the limb the way you want, as it does not make much difference. Chances of its union without any Intervention are unlikely.
How much is the pain, now?
Considering him like my father, I have two suggestions for him-
1. Minor surgical procedure with K wire fixation-In this under x-ray control bone piece will be brought together and held in place by 2-3 k wire. They will be passed through the skin without making an incision in the skin. This is a day care procedure and patient may be discharged on the same day. I will prefer this as chances of union are very good. Most of the time bone union occur in 6-8 week time.
2. Open reduction and plate fixation-I will keep this as a reserve procedure.
As far as not going for any of the above procedure his life will be miserable that is having pain,disability.Anaesthesia is much more advanced today and this procedure may be done under brachial block(only the suffered limb is anaesthetized).
Hope this helps in decision making.
Above answer was peer-reviewed by
 
Follow-up: Suggest treatment for shoulder fracture 14 minutes later
Hi Dr XXXXXXX

Thanks for answering my Question. yes it will help.
X-ray are latest.
Yes pain is there because it is not completely healed. We have kept his hand open without any patti. Should we cover ?
Can I know how many days or week atleast we can avoid surgery. Because he is very weak as of now, since he was on rest from past 2 months because of spinal fracture, so we are thinking atleast take some time so that his body get little recover to take this surgery further.

So, please suggest us the maximum time we can take to avoid this surgery so that after some time he will be healthy to take this further.

XXXX
 
 
Answered by Dr. Mukesh Chugh 1 hour later
Brief Answer:
As follows

Detailed Answer:
Hello
You may keep the limb in shoulder immobilizer (readymade belt) to hold the limb in place and to reduce pain. You must visit a hospital to get the necessary blood test and fitness certificate for surgery and leave it the surgeon to decide the appropriate time for surgery. But anyway a wait period of 2-3 week should be sufficient to make him healthy and to arrange other things.
Hope your query is answered and I shall be glad to answer any further query.
Take care



Above answer was peer-reviewed by
 
Follow-up: Suggest treatment for shoulder fracture 5 minutes later
Thanks Dr.
so on this basis we can avoid surgery for atleast 2-3 weeks and can keep his hand in the same open position if belt is not possible. Please inform me if I understood it correctly that atleast to make him healthy we can avoid surgery for 2-3 weeks and nothing will happen to his hand until.

Thanks
XXXX
 
 
Answered by Dr. Mukesh Chugh 8 minutes later
Brief Answer:
Nothing will happen during the waiting period

Detailed Answer:
Namaste
If belt is not available keep the limb in arm pouch/triangular sling/cuff and collar sling just to make him comfortable.
Yes, you got it correct nothing will happen to his shoulder, hand if you wait for 2-3 week.
Take care
Above answer was peer-reviewed by
 
Follow-up: Suggest treatment for shoulder fracture 5 minutes later
Sure Thanks Dr.

I forgot to ask this Question in starting "When you said it is not healed properly" Dr. you also don't think any other alternative of this broken bone solution apart from surgery.

Thanks
XXXX
 
 
Answered by Dr. Mukesh Chugh 18 minutes later
Brief Answer:
As follows

Detailed Answer:
Hi XXXXXXX it is a case of non union and needs Intervention as discussed earlier.You should utilize 2-3 week time for his health,blood test,choosing the surgeon and hospital.
Take care
Above answer was peer-reviewed by
 
Follow-up: Suggest treatment for shoulder fracture 6 minutes later
Thanks Dr.
 
 
Answered by Dr. Mukesh Chugh 8 minutes later
Brief Answer:
Thanks

Detailed Answer:
Namaste
I really appreciate your concern for your father. God bless him.
In future you may contact directly to me at http://bit.ly/drmchugh
If you have more queries to ask you may or please close the present discussion.
Take care
Above answer was peer-reviewed by
 
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