How to manage shoulder fracture?
Q: I had slipped 4 months back and injured my left shoulder. There was a fracture but my doctor said that nothing was reqired to be done. After some time I was advised to go for physiotherapy which I did for two weeks. I still has pain at a particular angle - when I stretch my arm sraight I get severe pain. I was advised to go for MRI and the report is as under: MRI of the left shoulder was performed using T1 and T2 weighted sequences in multiple planes. A subtle hyperintense signal is detected within the supraspinatus tendon, on T2 weighted images. It appears isointense on T1 weighted images and represents a partial tear. At its insertion, the marrow within the head of humerus reveal altered intensity, appearing hypointense on T1 and hyperintense on T2 weighted images. Cortical discontinuity is detected in this region and represents a fracture. The anterior portion of the glenoid labrum appears hyperintense on T2 weighted images, suggestive of partial tear. Mild synovial effision is seen, with fluid tracking along the bicipital tendon. Degenerative changes of the acromio-clavicular joint are noted. Rest of the visualised bones and soft tissues appear normal. Impression: Partial tear of the supraspinatous tendon; Fracture of the greater tuberosity of humerus with contusion of the surrounding marrow; Partial tear of the anterior labrum. I showed the report to an Orthopaedic surgeon who suggested either arthroscopy or regular physiotherapy. He also advised me to consult some senior consultant. I stay at a remote place. I want to know whether only physiotherapy would be sufficient.
A:You have now got the exact diagnosis from MRI and if your age is more than 50 years then physiotherapy is the first line of treatment and you should try this for atleast two months. If you are less then 50 years of age or if you do not get better in two months then one has to think seriously in terms of the operation for repair of rotator cuff.