Surgical treatment may not be the best fix for common types of shoulder injuries, a new study revealed. Most cases of shoulder injuries, the dislocation of the acromio-clavicular joint, can be treated better through physical therapy, without causing any further complications.
Orthopedic surgeons said that patients who preferred wearing a sling and go through rehabilitation recover faster, but patients who prefer surgery feel better about how their shoulder looks after the procedure is done. Surgical treatment involves the use of plate and screws to reconnect the joint.
In a paper issued in the Journal of Orthopaedic Trauma, researchers engaged 83 patients who had dislocated shoulders in a randomized clinical trial. The first half of the group was treated with surgery and rehabilitation, while the second half wore a sling and received physical treatment.
For two years, researchers monitored each patient's level of disability, and tracked complications that had occurred.
After three months, researchers said that patients who were not treated with surgery had more shoulder mobility, and 75 percent went back to their normal routine. Meanwhile, of the patients who received surgery, only 43 percent managed to go back to work.
Researchers also said that seven of the patients who received surgery suffered major complications such as a loose plate or an infection, while seven others experienced problems such as numbness.
Of the patients who did not receive surgery, two cases of major complications occurred. These were mostly caused by falls during recovery period and therefore worsened the injury. Some of these non-surgical patients also complained about the appearance of their rehabilitated shoulder.
Orthopedic surgeon Dr. Michael McKee from St. Michael's Hospital said that one of the main advantages of surgery was that the dislocated joint was put back in its place and that the shoulder will look symmetrical.
McKee said that appearance should be a consideration but orthopedic surgeons should still think twice before recommending surgery for a shoulder injury.
He also said that patients who prefer physical therapy and choose not to undergo surgery often get back to work earlier, experience fewer complications and less disability within the first months after their injury.
Shoulder injuries are most commonly caused by excessive, strenuous and intense physical activities, but a fall or an accident can also lead to the dislocation of the AC joint.
Photo: A. Sparrow | Flickr