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Plate tear to the Labrum and Hill Sachs fracture

post #1 of 16
Thread Starter 

 

Early last month I was heading down our steepest run, when suddenly, my downhill ski popped off.  I crashed about 100 yards later and when I went down, I landed on my fully outstretched arm and basically blew it out of the socket.  I have re-dislocated it 10 more times since then.  I injured this same shoulder 16 years ago and had surgery to tighten everything up, and up until last month, all was good. 

I finally got into see a highly respected orthopedic sports medicine doctor yesterday.  He said I have a plate tear to the labrum and a hill sachs fracture to the humeral head.  He also said the glenoid capsule will need to be tightened.  He couldn't tell by the MRI, but thinks there may be some bone loss too.  If that's the case, he'll probably do the laterjet procedure that Dr. Mark over on TGR talks highly of.  He won't know there until he has the scope in, and can get a better view.  He did tell me that I have about 6 months of recovery ahead of me.  Having use of only one arm and caring for my 1-1/2 year old should be a bit of a challenge.

I've still been teaching since my crash in early January because I wasn't quite ready to hang up my skis then and I figured that the damage was already done.  I just tie my arm down to my torso with a belt.  My son let me borrow his seatbelt belt (Lincoln) because it was easy on and off.  I have now however, gained the nickname "seatbelt annie" from a few of my ski patrol friends. :D.

everest.jpg

 

post #2 of 16
I had arthroscopic repair of my labrum and capsular reduction 12 days ago. I did not have a Laterjet, as I did not have major defect of the glenoid.

Good luck with your surgery and recovery.
post #3 of 16
Thread Starter 
Thanks TSW!  Best wishes for your speedy recovery!
post #4 of 16
Thread Starter 
Third day post op and the pain pump is empty!  OUCH!  My arm feels like it's hanging by a thread.  It is kind of nice getting the feeling back in my hand.  I just changed my little girl's poopy diaper with one hand and a few toes.... A talent that until now hadn't been discovered!   Awesome!
post #5 of 16
At least you had the pump this long. My anesthesiologist doesn't like to leave them in, so I got a block, then dealt with the shoot-me-now pain about 18 hrs later.

It gets better....slowly

Don't be shy about using the percocet/vicodin or whatever they gave you. There's no point in "gutting it out", as the meds don't work as well once the pain gets too bad.

I'm 4.5 weeks postop. Was released from the immobilizer sling yesterday which is a huge personal victory. I start  formal PT on Monday.

Post pix of the one handed/3 toe poopy diaper technique
post #6 of 16
Thread Starter 
Darn TSW.  I missed that photo op.  Maybe next time.

I feel much better today; 4th day out.  I took my arm out of the sling for a while last night and squeezed on the exercise ball on and off for a couple of hours.  I also finally took all of the bandage material off and the 100 yards of very sticky surgical tape and took a shower.  There are 3 small incisions:  one on the front, one on the side and one in the back.  My husband thinks that he remembers the doctor saying there were 8 anchors, but I'll find out on Wednesday.  8 sounds like a lot.
post #7 of 16
Thread Starter 
Went and got the stitches out on Wed.  The doctor said that I had a grade 4 labrum tear.  He used 4 anchors.  2 in front and 2 in the back.  Also the bony bankhart lesion was really prominent and there were some really big bone chunks that they removed.  I've been reading a little about allografts (sp).  I guess they do those all of the time with knees when the head of the bone has been damaged, but it hasn't been widely used in shoulders yet.  Hopefully what I had done will hold up.  I don't want to go through this again!  PT is going great though!  My therapist was really impressed with my ROM today.  I've been working with the pulley quite a bit and it's really helping!  Haven't needed any pain meds but have been taking Naproxen and using ice packs after exercising.
post #8 of 16
Nice to hear it's going well.
I have 4 anchors in one shoulder, 5 in the other

Interesting that your ortho has you in PT already. Around here, the conventional wisdom is 4-6 weeks of complete immobilization before beginning rehab to allow the repair to mature. Early ROM is not the goal. In fact, the opposite is desired so that the joint doesn't get overstretched early. Other places start PT earlier. My brother-in-law had a labral repair in MI and he too started PT right away.

I'm 6 weeks out now and doing great. I've been in PT for a week and have good mobility, minimal discomfort and am starting to regain strength. 4 more weeks until I can start riding the road bike again...
post #9 of 16
Thread Starter 
4 in one shoulder and 5 in the other??? You do good work!  :D

I thought pt would be further down the road too.  My insurance has become really crappy and is only allowing for $1,000 worth of therapy.  That's like a week I think.  I asked the therapist to give me a list of exercises that I can do at home and to cut my therapy schedule to only once a week instead of the 3x that my doctor ordered so that I can extend the time out to where I can get their help when I need it more.
post #10 of 16
Glad its going, and going well.

It will be good to have you back at full attack mode next season
brad
post #11 of 16
Thread Starter 
Thanks Brad! 

I'm hoping to have a little more fun next season.  Skiing just isn't the same with your arm belted to your side!
post #12 of 16
Thread Starter 
Man is this getting discouraging!!!!  My rotation is soooooo limited!   I'm going to pt once a week and I've been working my butt off, 2 - 3 times a day on my own trying to loosen this shoulder and arm up and it's not helping!  My therapist wants me to add 2 more days but insurance is gone after 6 more visits.   When I pull my arm straight up, I can go pretty far up, but when I try to rotate to the side, my arm shakes like crazy as I'm trying to stretch it, but I'm not gaining any range of motion!  If any of you have some good suggestions for some exercises that I can do at home, I'd really appreciate it!
post #13 of 16
Quote:
Originally Posted by Snowmiser View Post

Man is this getting discouraging!!!!  My rotation is soooooo limited!   I'm going to pt once a week and I've been working my butt off, 2 - 3 times a day on my own trying to loosen this shoulder and arm up and it's not helping!  My therapist wants me to add 2 more days but insurance is gone after 6 more visits.   When I pull my arm straight up, I can go pretty far up, but when I try to rotate to the side, my arm shakes like crazy as I'm trying to stretch it, but I'm not gaining any range of motion!  If any of you have some good suggestions for some exercises that I can do at home, I'd really appreciate it!

Snow....
you are not going to like what I have to say, but I'll say it anyway.

It's your health. Pay for the PT. Don't try to do this on your own. There's a high chance for poor outcome if you do.
This is NOT a rehab that can be rushed. it's soft tissue healing, and doing too much too soon can lead to major problems down the line.
post #14 of 16
Thread Starter 
Thanks for the message TSW!  Maybe my therapist is expecting to much too soon and it's rubbing off on me!  He's afraid I'm going to lock-up if I don't get more range of motion there soon.  That's not something that I wanted to hear!

My husband called me from work today and heard how down I was and told me to have them keep me on the schedule even after the insurance runs out.  I totally agree with you...it's my health and I need to take care of it!  Besides....If Momma ain't happy...ain't nobody happy!  :D   Thanks for your excellent advice.
post #15 of 16
Thread Starter 
Things are looking up!

I'm starting to see great improvements with my ROM of my shoulder.  I'm still pretty tight trying to move it to the side, but what a difference a week makes!  I've been really dedicated on working at it at home with a pulley hooked to the door and with walking the wall and rolling a ball on the wall.  That along with my pt's help make me confident that I'll be back to normal (well...normal for me ) in no time.  I still don't have the green light to start swimming, but I'll get there before the lake warms up.
post #16 of 16
Thread Starter 
I had my 7 week post op. appointment last week.  The doctor was pretty happy with where I was at. In fact, he said if I had come in with more range of motion than I currently have, he would have been upset with me.  He said he wants me to go REALLY slow on stretching things out.  He told me to plan on at least 3 more months before I have full range of motion and that would even be pushing it.  If he had done the laterjet procedure, he would have wanted me to aggressively work it, but because he decided to try to take the conservative approach and do the capsular reduction and labral anchors; which only involve the soft tissues, that I need to really take it slow.  Guess I'll be driving the boat this summer instead of being behind it!
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