Sometimes you feel that your arm is not lifting up and you worry if you have got paralysis the simplest thing is after the fall tries to move your fingers and your elbow if you are able to do that extra paralysis. it’s only to do with the shoulder joint that you are unable to lift it up, the reason being when you have the muscle that is torn in the shoulder joint. If you see these muscles will help the shoulder joint to go up and down if these are torn then you are unable to do it because it’s disconnected.
A lot of people are worried that they are unable to do and they get they are worried that they got paralysis which is not true. The majority of this can heal without surgery the first and foremost thing we do is if we suspect a rotator cuff tear we usually at our orthopedic hospitals in Hyderabad do an MRI scan to see if there is a tear if so is it a partial tear or a full tear. when we say partial only a portion of this is torn so we don’t have to operate you just let it settle with some rest and it’ll heal on its own and even though a complete tear if it’s in a position we just keep rest and again we don’t need the surgery you need surgery when there is a complete tear and the muscle is going to come back so in those scenarios we need to have surgery done.
Now as we mentioned earlier if we don’t have surgery if you can see gradually this muscle is going to go back so there is nothing stopping this bone to sit it down, gradually it goes up so essentially it goes up until it moves meets this clavicle the shoulder blade.
The bone there on the top so it touches there and it starts to rub that’s called acromion so you get arthritis and any movement is very painful causing a lot of sounds. Now there is an English proverb saying a stitch stitching time saves nine, Simple as that if we going to stitch it in time it’s going to save a major disaster the reason being once the ball goes starts to move up and touches the top bone we can’t do anything except for doing a technically more challenging operation it’s called a joint replacement which is called a reverse shoulder arthroplasty now if you see this is the ball and socket like this in those scenarios we have to reverse and put the ball there in the socket here. So the shoulder doesn’t move up this is a successful operation but as we mention we want to avoid it at any cost and we see a lot of people asking that to treat without operation like we discussed earlier if it’s cut and it’s not moving out and if there’s a partial cut we don’t usually need surgery.
Once it we know that it is torn and it’s going to move there’s no point in waiting for the reason being when once this is a muscle is torn and it’s starting to move you leave it too long it’s like you know you are holding the tent if you hold the tent too hard it’s going to give off similarly once it is turned and it’s moved back we try to pull it and stitch it won’t be as good repair as the initial stage number one. Number two once you have the initial injury everything is raw so you stick it back like fevicol it sticks whereas if you leave it for
months together it becomes rough and it we have a lot of what is called scar tissue we have to clear all that stick kick back and then stitch it even though we do the best possible treatment sometimes the healing might not be better so my suggestion as soon as you have an MRI scan suggests surgery please go for it.
Now as we discussed this is a keyhole surgery the beauty is you have three or four small no keyholes which take one stitch later on so and you have a brace and you are up and out by evening so suppose we operate in the morning by evening your out and around and the next day you should be home if the pain is more usually you take another 24 hours to stay in the hospital usually these type of keyhole surgeries are quite safe but still there’s a chance of infection bleeding and you can have some nerve injuries.
While doing the surgery and failure of the operation when we say that the aim of the operation is to stick it back in spite of best stitching and best methods being performed if the tissue is not strong enough or if your bone is not strong enough to get it stuck it might come off and there are rare chances that the surgeon might also have done a problem wherein the stitching is not proper in those scenarios also it can fade so the chances of this failure is about five percent we if at all there is a problem we will be able to sort it out for about four patients out of the five and there might be one or two patients in hundred that no you can’t help it much.
Yes like we mention if it is done at the initial stages the chances of sticking are good and you should be able to get full movement and you should be able to do almost normal activities in life and usually after stitching we used we’ll give you a brace for six weeks so that the muscle is not under pressure so you can give it some time so it heals nicely and then after some period like about two-three weeks we get to move your elbow and shoulder to some extent at six weeks we take off the brace and get you to do all the exercises we go in stepwise fashion at two weeks there is something called passive exercises that’s four weeks we do active-assisted and at six weeks we do active exercise so this is stepwise so that there is not much force on the repaired area and we aim to get 100 results with that not all rotator cuff injuries need surgery and as we discussed before the ones that need surgery please go for it. Even you are 80 still we have operated on a lot of patients who are 80 plus the reason being now the longevity in India has increased significantly and you want to be independent imagine unable to lift your shoulders you can’t even comb your hair you can’t even wash and clean yourself have you’re not self-made you have to depend on somebody which probably you might not like it’s a simple operation and the healing rate is very good unless you are a smoker and you take regular alcohol these are the two things we suggest and in people having diabetes again the chance of healing is a little bit slower apart from these regular core conditions we suggest you have surgery irrespective of the age unless you’re not fit for anesthesia we hope you recover well.