Q. My 17-year-old son was snowboarding over Presidents’ Day weekend and fell. He dislocated his left shoulder, which was very painful. He had it put back in place at the hospital. They gave him a sling and told him to see a doctor when he got back to Miami. He saw an orthopedic surgeon, who did an MRI. He told us he needed surgery. My son has no pain now and his sling is off. Is surgery really necessary?
A. For a young person to dislocate a shoulder, it is usually means they have torn the cartilage in the shoulder (labrum), which stabilizes the shoulder. The labrum and surrounding ligaments usually do not heal in the right place and under the right tension, thus rendering the shoulder inherently unstable and more likely to dislocate again.
Statistically, teenagers who dislocate their shoulder have about a 95 percent chance to dislocate again. People in their 40s have about a 50 percent chance of redislocation.
The MRI can also show associated injuries to the rotator cuff tendon and the ball part of the shoulder (HillSachs lesion). Although physical therapy may help, many young patients with such a high risk of reinjury will benefit from surgery to stabilize the shoulder. Most times, the surgery can be done arthroscopically (minimally invasive).
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I recommend you discuss this further with your son’s orthopedic surgeon. If you have additional concerns, you may want to get a second opinion.
Dr. Harlan Selesnick is team physician of the Miami Heat and director of Miami Sports Medicine Fellowship, Doctors Hospital. Email questions to HarlanS@baptisthealth.net.