Post Surgical Management Part 2: Upper Extremity Surgical Interventions
Presented by Haideh V. Plock
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This course is part of our OCS Prep-Program. Learn more about the full prep-program here: MedBridge OCS Prep-Program.
This is the second course in a three-part series. Course I covered the principles of tissue healing along with common spinal surgeries and Course III covers lower extremity surgical interventions. I would encourage you to watch course I in preparation for this course on upper extremity surgical interventions. This course will discuss how tissue healing affects management of upper extremity post-surgical patients and present rehabilitation considerations for more common upper extremity surgical procedures encountered in an outpatient setting.
This is part two of a three part series covering postsurgical management. Be sure to watch:
Post Surgical Management Part 1: Basic Principles and Spinal Surgery
Post Surgical Management Part 3: Lower Extremity Surgical Interventions
Meet your instructor
Haideh V. Plock
Haideh graduated with a double major in Kinesiology and Psychology from the University of California, Los Angeles in 1991. Upon completion of her Master’s in Physical Therapy from Boston University in 1993, she accepted a position at the Kerlan-Jobe Orthopedic Clinic. She worked there for the next 11 years specializing in…
Chapters & learning objectives
1. Subacromial Decompression
There are numerous extrinsic and intrinsic factors that contribute to subacromial impingement syndrome of the shoulder. Surgical interventions may be indicated with cases that do not respond to conservative measures to remove mechanical anatomical contributions to impingement syndrome.
2. Rotator Cuff Repair
Many of the same extrinsic and intrinsic factors that contribute to subacromial impingement syndrome can contribute to development of rotator cuff tears. In cases that do not respond to conservative care, acute traumatic tears, or active individuals with full thickness tears, surgical intervention may be necessary. An understanding of the surgical procedure, including the specific anatomical structures involved, is crucial to determine the appropriate rehabilitation course.
3. Superior Labral Repair
A common tear of the glenoid labrum occurs along the superior labrum in an anterior to posterior direction (SLAP). Forces that cause the humeral head to pull on the superior labrum and biceps anchor can cause tearing of these structures off the glenoid. These forces can be from multiple sources, including shoulder dislocation, repetitive overhead lifting, and throwing. A SLAP repair is often indicated when nonoperative interventions fail and require a guided rehabilitation program following surgery.
4. Total Shoulder Arthroplasty
The most common indication for total shoulder arthroplasty is advanced osteoarthritis with pain and range of motion limitations inhibiting functional ability. Most surgeons have very specific protocols following shoulder arthroplasty; however, clinical judgement should not be discarded. An understanding of tissue healing as well as the impact of comorbidities and general health on the rehabilitation progression needs to be included in the post-operative plan.
5. Carpal Tunnel Release
When symptoms associated with median nerve compression at the carpal tunnel do not resolve with conservative treatment, carpal tunnel release surgery may be indicated. Many factors contribute to the success of carpal tunnel surgery and can impact the length of the rehabilitation after this procedure.
