“I guess the geyser of saline solution shooting out of that dude’s shoulder is normal huh?”

12 June 2013

            I had the incredible opportunity to shadow Dr. Greef in the operating theater today, which took place at a private practice about a 15 minute drive off campus. Dr. Greef is an orthopedic surgeon and a leader in shoulder specialists. I was surprised at how rough shoulder surgery appeared when I walked into the operating room to see Dr. Greef pounding a pilot hole into the head of the humerus of our first patient with a hammer and punch. Also, the amount of saline solution being pumped into the shoulder was causing it to swell up to twice its normal size. This not only made you looked jacked, but also caused a fountain of liquid to come shooting out of your shoulder whenever a probe was inserted or extracted.

            The first patient had a partial tear of the rotator cuff which was mended easily enough with some screws and suturing. The second patient was a little more involved, suffering from impingement of the rotator cuff by the acromion (the outer end of the scapula attached to the collar bone) and a labral tear (labrum is cartilage found in the socket of the shoulder joint). The impingement of the rotator cuff was solved by cutting away the tip of the acromion. The labral tear was corrected by cutting the biceps tendon and reattaching it lower on the humerus with a screw. The third patient had a large tear in the rotator cuff. This was corrected by four screws and some extensive suturing. The biceps tendon was also cut and reattached lower on the humerus with suturing so that it would not be trapped underneath the repaired rotator cuff. Dr. Greef informed me that more severe rotator cuff tears can require cutting the humeral ligament to give an extra centimeter of slack, allowing the cuff to be more easily sutured back together. The fourth patient required acromioclavicular (AC) joint repair, which was a fairly quick operation. The fifth and final patient had a subscapularis tear, but unfortunately I was unable to observe the entire procedure as I had to catch my ride back to campus.