Subacromial decompression (open)

Question 1

What is the purpose of the surgery?

Answer 1

To decompress the impingement of the rotator cuff

Question 2

What type of surgery is this?

Answer 2

Open surgery

Question 3

Describe the procedure

Answer 3

1. Deltoid is detached from the acromion
2. 5cm Split in made distally
3. Undersurface of the acromion is removed (acromioplasty)
4. Deltoid is reattached

Question 4

Where is the incision?

Answer 4

Coronal

Question 5

What are the main complications?

Answer 5

Detachment of the repaired deltoid

Axillary nerve injury

Question 6

Post-op precautions (0-2weeks)

Answer 6

1. No active shoulder flexion

2. Use of sling

Question 7

Physio 0-2 weeks

Answer 7

1. Reinforce precautions
2. Teach pulley exercises
3. Teach active assisted exercises
4. External rotation exercises with a stick
5. Isometric cuff strengthening
6. Elbow, wrist and hand exercises
7. Scapula setting exercises

Question 8

Physio 2-6 weeks

Answer 8

1. Wean off sling
2. Progress scapula exercises
3. Start active flexion exercises
4. Correct movement patterns
5. Progress rot cuff exercises
6. Begin deltoid strengthening

Question 9

Physio 6-12 weeks

Answer 9

1. Deltoid strengthening program

Question 10

Milestones

Answer 10

Week 4:
Full PROM achieved

Week 6:
AROM returned to preoperative level

Week 16:
Full ROM gained