Shoulder & Elbow
Information on common injuries treated by Rapid Access Orthopedics
Elbow Fractures & Dislocations
An elbow fracture is a break in one or more of the bones that make up the elbow joint. The bones in the elbow joint are humerus — the upper arm bone, Ulna — the larger of the forearm (lower arm) bones, Radius — the smaller bone in the forearm. Early diagnosis and treatment significantly improves recovery from an elbow fracture. Depending on the severity of the fracture, a temporary cast or splint may be used to hold the bones in place for healing. In severe cases, a metal plate and screws might be surgically implanted to repair the fracture. Healing time typically takes about 8-12 weeks. During that time, range of motion exercises under the guidance of a physician will be employed to improve motion and strengthen the area.
Nursemaid’s elbow is a common injury of early childhood. It is sometimes referred to as “pulled elbow” because it occurs when a child’s elbow is pulled and partially dislocates. The medical term for the injury is “radial head subluxation.” Because a young child’s bones and muscles are still developing, it typically takes very little force to pull the bones of the elbow partially out of place, making this injury very common. It occurs most often in children ages 1 to 4, but can happen any time from birth up to age 6 or 7 years old. Although the injury may cause initial pain, a doctor or other healthcare professional can easily reset the elbow, quickly relieving any discomfort and restoring arm movement.
Tennis & Golfer’s Elbow
Tennis elbow, or lateral epicondylitis, is the most common injury in patients seeking medical attention for elbow pain. Exactly what causes tennis elbow is unknown, but it is thought to be due to small tears of the tendons that attach forearm muscles to the arm bone at the elbow joint. Golfer’s elbow, also called medial epicondylitis, is similar to its counterpart, tennis elbow. The primary differences between these conditions are the location of the pain and the activity that leads to injury. However, both conditions are caused by overuse of the muscles and tendons of the forearm.
Clavicle fractures are most common in children and young adults, typically occurring in persons younger than 25 years. The superficial location, the thin mid-shaft, and the forces transmitted across it make the clavicle a common site for injury. The most common mechanism of injury is a forceful fall with the arm at the side, which commonly occurs during contact sports. Surgery is not usually necessary for clavicle fractures, but can be recommended for patients with excessive displacement or shortening of the fracture, or if the fracture end is tenting the skin.
Shoulder dislocations are injuries that occur when the ball of the ball-and-socket shoulder joint comes out of position. Usually a shoulder dislocation occurs after a sports injury or trauma, such as a fall. Shoulder dislocations are painful, and immediate treatment is necessary. Once the shoulder is reduced, different management options can be considered. Determining the appropriate treatment depends on a number of factors including exactly what was damaged in the shoulder, how many dislocations have occurred, age of the patient, activities or sports performed, and other factors.
Proximal humerus fractures are common orthopedic injuries that usually occur as a result from a direct blow to the shoulder, either in a fall or as the result of a high-energy trauma. They usually can be treated conservatively with immobilization but more complex fracture patterns often require operative treatment.
A shoulder separation refers to the stretching or tearing of ligaments where the collarbone (clavicle) meets the shoulder blade (scapula), also called the acromioclavicular or AC joint. If these ligaments partially or completely tear, the clavicle can slip forward and detach from the scapula. A shoulder separation is usually caused by an impact to the front of the shoulder or by falling on an outstretched hand.
Rotator Cuff Tears
The shoulder is a complex, very mobile joint with over twenty muscles involved in its motion. Four of these muscles are involved in the rotator cuff, a group of four tendons that join together and facilitate rotation of the arm bone, or humerus, at the shoulder. The rotator cuff tendons are subject to a lot of use, and at some point can tear. Rotator cuff tears are usually fairly painful and can occur as degenerative tears in middle age after years of wear and tear, or they can occur in younger athletes such as a baseball pitcher as a result of high demand repetitive usage. Rotator cuff injuries have a spectrum of severity, ranging from inflammation of the rotator cuff and bursa, to partial tearing of the rotator cuff, and finally to complete tearing of the rotator cuff. A partial rotator cuff tear occurs when the tendon starts to break down or tear, but has not actually torn completely through the tendon. A partial rotator cuff tear may gradually worsen over time and eventually become a full thickness tear, or it may suddenly “snap” and become a full thickness tear as a result of trauma, or from trying to lift a heavy object. A full thickness rotator cuff tear usually starts out as a small tear, which can progress over time to a medium or large tear, or even a massive tear.
The labrum is a ring of fibrous cartilage that surrounds the socket of the shoulder (the glenoid). The labrum helps to deepen the socket and provide stability to the shoulder joint. It is also where the shoulder capsule attaches. The labrum also helps to provide some shock absorption to the shoulder and cushion the joint. A torn labrum is classified by its location. Your surgeon may refer to your labral tear by a specific name depending on where it is.
The biceps muscle is in the front of your upper arm. It helps you bend your elbow and rotate your forearm. It also helps keep your shoulder stable. Tendons attach muscles to bones. Your biceps tendons attach the biceps muscle to bones in the shoulder and in the elbow. If you tear the biceps tendon at the elbow, you will lose strength in your arm and be unable to forcefully turn your arm from palm down to palm up. Once torn, the biceps tendon at the elbow will not grow back to the bone and heal. Other arm muscles make it possible to bend the elbow fairly well without the biceps. However, they cannot fulfill all the functions, especially the motion of rotating the forearm from palm down to palm up. This is called supination. Significant, permanent weakness during supination will occur if this tendon is not surgically repaired.
401 South Van Brunt St, Englewood, NJ 07631
Located on the 3rd Floor
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Monday – Friday | 8:30am – 6:00pm