Bicep Tenodesis

Bicep Tenodesis

Bicep Tenodesis Treatment

Biceps tendonitis is usually treated with a surgical procedure called biceps tenodesis. Biceps tendonitis is also known as biceps tendon tear. The surgery is usually recommended for people that suffer from shoulder pain because of biceps tendonitis. The pain is usually caused by inflammation and doesn’t improve with non-surgical treatment.

Biceps tenodesis procedure is recommended for people looking to regain mobility and strength in their shoulder area. Damaged parts of the bicep tendon are removed during the procedure.

Thomas & Bigler Knee and Shoulder Institute, led by board certified orthopedic surgeons Dr. Steven C. Thomas and Dr. Gregory T. Bigler, provides orthopedic surgery to patients in Las Vegas, Nevada, while also serving areas such as greater Pahrump, Bullhead City, Lake Havasu, and Mesquite, NV.

Symptoms of Biceps Tendonitis

Traumatic injury or repetitive movement of the shoulder may cause biceps tendon tears. Symptoms include:

  • Sharp and sudden pain in the upper arm
  • Snapping or popping sound
  • Cramping of biceps
  • Tenderness or pain in the elbow or shoulder
  • Weakness in elbow or shoulder
  • Appearance of bruises
  • Difficulty rotating the arm
  • Popeye muscle or a bulge in the upper arm

Understanding Biceps Tenodesis

This is a surgical procedure that helps in treating biceps tendonitis. Biceps tendon tear occurs because of an abrupt injury or overtime with repetitive motion. Biceps tendon may tear entirely or partially. However, a majority of people don’t require a surgery and are able to live their lives without any trouble.

You may lose some mobility and strength with biceps tendon tear in your shoulder. However, it may not be enough for you to experience difficulty in performing everyday tasks. You may need to get a surgery if you want to regain strength and mobility in your shoulder.

How Does it Work?

There are several ways of performing a biceps tenodesis procedure. Most procedures fit into soft tissue and hard tissue categories.

Soft Tissue Procedures

There are two primary techniques under this approach:

  • Open keyhole procedure: An opening in the keyhole or humerus is created. This is to insert tiny instruments for stitching the rolled-up end of the bicep into place.
  • Pitt technique: An interlocking pattern of stitches is created using two needles. The tendon is then tied to the shoulder ligament.

Hard Tissue Procedures

The two primary techniques under this approach are:

  • The surgeon will first detach the biceps tendon to create a hole at the top of the arm bone. The tendon is attached to this hole at one end. The other end is secured in place by screwing it to the arm bone.
  • The biceps tendon is detached in this approach as well. However, it is attached to a button that is slid into the hole at the top of the arm bone.

Biceps tenodesis is a highly successful procedure for the most part because it’s well practiced. People report better flexibility, reduced pain, and better strength. They also find it easy to return to their activities and sports. Experts recommend getting the procedure done at least three months after the injury for best results.

Orthopedic surgeons Dr. Thomas and Dr. Bigler receive patients from Las Vegas, Nevada as well as greater Pahrump, Bullhead City, Lake Havasu, and Mesquite, NV for orthopedic surgery.

Contact Board Certified Surgeons Dr. Bigler or Dr. Thomas at the Knee and Shoulder Institute in Las Vegas, NV to Schedule an Appointment:

If you would like to schedule an appointment or learn more about the Knee and Shoulder Institute procedures & treatments performed by Las Vegas, Nevada board-certified surgeons Steven C. Thomas, MD and Gregory T. Bigler, MD. Contact the office today click here.

Serving patients from and around greater Las Vegas, Lake Havasu, Bullhead City, Mesquite, Pahrump, Nevada

Arthroscopic Rotator Cuff Repair

Arthroscopic Rotator Cuff Repair

You can suffer from a rotator cuff tear after falling or another significant injury. Degeneration and prolonged breakdown of the associated tendon can also result in a rotator cuff tear. Pain while sleeping and radiating pain on the affected side are common symptoms of a rotator cuff tear. You may also experience arm weakness while trying to perform your daily activities.

Worsening pain is an indication that the tear is getting bigger. It is important to speak with an orthopedic surgeon if you experience these symptoms or something similar. Your surgeon will want you to get an MRI or Magnetic Resonance Imaging to identify and confirm the injury.

You may be able to take care of your rotator cuff tear without undergoing any surgery if detected early. Nonsurgical treatment options may include cortisone injections, anti-inflammatory medicines, and physical therapy, among others.

Your surgeon may recommend you to schedule the surgery if the nonsurgical approach doesn’t yield required results. The goal of any shoulder specialist is to help you restore your strength while managing your pain.

Thomas & Bigler Knee and Shoulder Institute, led by board certified orthopedic surgeons Dr. Steven C. Thomas and Dr. Gregory T. Bigler, provides orthopedic surgery to patients in Las Vegas, Nevada, while also serving areas such as greater Pahrump, Bullhead City, Lake Havasu, and Mesquite, NV.

Repairing Arthroscopic Rotator Cuff Tears

Arthroscopic rotator cuff repair is an advanced and revolutionary procedure for treating rotator cuff tears. This is a minimally invasive technique which can yield the same results as conventional rotator cuff repair procedures.

Arthroscopic rotator cuff repair or shoulder arthroscopy is a great way of treating tears in the rotator cuff. The entire shoulder joint can be evaluated by experienced surgeons. They use specially designed devices and instruments for fixing the tears using tiny incisions. Arthroscopic repair is particularly appropriate for large tears since it helps in visualizing and accessing the tear.

The following procedures are used to restore painless and normal motion:

  • Débridement: This is used in cases where the rotator cuff is loose and degenerated. The rotator cuff may have frayed tissue on the edges, which is removed to give healthy tissue access.
  • Mobilization: The rotator cuff is brought back to a normal position without putting undue tension. Margin convergence is used for larger tears.
  • Suture Anchors: Specially designed devices are used for fixing the tear in place to secure the bone to the cuff tear.

All-Arthroscopic Repair

Arthroscopic rotator cuff repair is of two types – all arthroscopic repair and mini-open arthroscopic repair. Arthroscope is used by the surgeon to look at the rotator cuff. It is a miniature camera which is guided after making a tiny incision on the effected joint. The camera will transfer images on a video monitor.

Mini-Open Arthroscopic Rotator Cuff Repair

This procedure makes use of a more advanced technology to repair the rotator cuff tear. The surgeon can directly view the tendons without using a screen or video monitor. It allows doctors to evaluate damage (if any) in the surrounding areas.

Orthopedic surgeons Dr. Thomas and Dr. Bigler receive patients from Las Vegas, Nevada as well as greater Pahrump, Bullhead City, Lake Havasu, and Mesquite, NV for orthopedic surgery.

Contact Board Certified Surgeons Dr. Bigler or Dr. Thomas at the Knee and Shoulder Institute in Las Vegas, NV to Schedule an Appointment:

If you would like to schedule an appointment or learn more about the Knee and Shoulder Institute procedures & treatments performed by Las Vegas, Nevada board-certified surgeons Steven C. Thomas, MD and Gregory T. Bigler, MD. Contact the office today click here.

Serving patients from and around greater Las Vegas, Lake Havasu, Bullhead City, Mesquite, Pahrump, Nevada

Bankart Repair

Bankart Repair Treatments

Bankart Repair in a minimally invasive procedure that will repair torn shoulder ligaments. Ligaments in the shoulder can tear when the shoulder dislocates or is bent out of place. The procedure makes use arthroscopy that helps in attaining faster, smoother and a less painful recovery.

Thomas & Bigler Knee and Shoulder Institute, led by board certified orthopedic surgeons Dr. Steven C. Thomas and Dr. Gregory T. Bigler, provides orthopedic surgery to patients in Las Vegas, Nevada, while also serving areas such as greater Pahrump, Bullhead City, Lake Havasu, and Mesquite, NV.

Shoulder Anatomy

Shoulder is responsible for the most motion in the human body as compared to all other joints. It is a marvel of stability and mobility. The humeral head or shoulder ball remains centered in the glenoid (joint socket).

Glenoid is responsible for offering stability to your shoulder. The ligaments help in restraining the shoulder. They also help in making the shoulder more stable and keeping it from moving beyond its motion range. Concavity compression helps the rotator cuff to hold everything in place.

Understanding Bankart Repair

The ligament and glenoid tear when the arm is bent backward. This can cause the shoulder ball to dislocate from the joint socket. Bankart lesion is a common ligament injury. This is when the ligaments get torn from the socket.

The shoulder may lose stability if the glenoid and ligaments don’t heal properly. This is why repairing the tear is so important. This repair is popularly called Bankart Repair.

Symptoms of Bankart Repair

These are a few symptoms of Bankart Repair:

  • Unstable joint
  • Repeated dislocations
  • Catching feeling
  • Shoulder aches
  • Feeling that the shoulder may dislocate

Diagnosing Bankart Tear

Your physician will take a look at your medical history and symptoms to assess whether you have actually torn the ligaments in your shoulder. They will let you know if you require Bankart Repair. Your physician may also order scans and x-rays for determining if there is any loss of joint space.

Arthroscopic Bankart Repair Procedure

Arthroscopy is usually performed to repair a Bankart lesion. This is a minimally invasive procedure that involves making small incisions for inserting a probe-like camera. The camera allows the surgeon to examine the injured area completely before attempting to make any corrections.

The surgeon will use the same incisions to insert specialized instruments during an arthroscopy for making the necessary repairs. All tears in the tendon, muscle and cartilage will be fixed after removing the damaged tissue. The incisions will be stitched after the procedure.

Recovering From Arthroscopic Bankart Repair

Patients need to keep their shoulder and arm immobilized after Bankart repair. You would have to wear a sling for at least a month. Physical therapy generally starts from day 5 of the surgery. Physical therapy may be required for a period of 4 months following the surgery to strengthen your muscles and improve the range of motion.

You may not be allowed to participate in contact sports for at least six months following the surgery. Orthopedic surgeons Dr. Thomas and Dr. Bigler receive patients from Las Vegas, Nevada as well as greater Pahrump, Bullhead City, Lake Havasu, and Mesquite, NV for orthopedic surgery.

Contact Board Certified Surgeons Dr. Bigler or Dr. Thomas at the Knee and Shoulder Institute in Las Vegas, NV to Schedule an Appointment:

If you would like to schedule an appointment or learn more about the Knee and Shoulder Institute procedures & treatments performed by Las Vegas, Nevada board-certified surgeons Steven C. Thomas, MD and Gregory T. Bigler, MD. Contact the office today click here.

Serving patients from and around greater Las Vegas, Lake Havasu, Bullhead City, Mesquite, Pahrump, Nevada

Shoulder Socket Fracture (Glenoid Fracture)

Shoulder Socket Fracture Treatment

A shoulder fracture happens when the center or rim of the socket fractures. This can cause swelling, pain, bruising, and other similar symptoms. Generally, a shoulder fracture occurs due to high-energy impact, such as sports injury, falling from a height, or a car accident.

Typically, shoulder fractures are treated using surgical methods. This is because the fractured bone is dislocated and out of place. It needs to be correctly adjusted, which can only be done by way of surgery. The bone will heal incorrectly if it is not placed in the right manner. You may be left with permanent shoulder damage in this case.

Thomas & Bigler Knee and Shoulder Institute, led by board certified orthopedic surgeons Dr. Steven C. Thomas and Dr. Gregory T. Bigler, provides orthopedic surgery to patients in Las Vegas, Nevada, while also serving areas such as greater Pahrump, Bullhead City, Lake Havasu, and Mesquite, NV.

Types of Shoulder Fracture

Shoulder fractures are not common injuries. They may happen because of significant injury to the shoulder, such as a car accident or a high fall. Glenoid fractures can be of two types:

  • Glenoid Fossa Fracture: Glenoid fossa is the central part of the socket. It is a far less common fracture and happens when the shoulder sustains extreme trauma. The glenoid fossa breaks in this type of fracture.
  • Glenoid Lip Fracture: This happens when the shoulder gets dislocated. The ball of the shoulder socket pushes against the socket rim, resulting in a clean break.

Symptoms of Shoulder Fracture

There are several types of symptoms accompanying shoulder socket fractures:

  • Swelling
  • Pain
  • Difficulty moving the shoulder
  • Bruising
  • Limited mobility in the shoulder
  • Grinding sensation when trying to move the shoulder

Nonsurgical Options for Shoulder Socket Fracture

Nonsurgical treatments generally get the job done when a shoulder socket fracture is not very severe. It will allow you to return to your every day chores. You would need to keep the shoulder in place with a splint, sling, or cast to ensure the bone heals as it should. Depending on the severity of the shoulder socket fracture, your shoulder may heal in a few weeks.

Bone stimulation is another process that helps in speeding up the healing process. The treatment uses low intensity pulsed ultrasound and low electric current. The body gets tricked into believing that there is an injury. It begins producing proteins essential for repairing cells in the injured shoulder.

Surgical Treatments for Shoulder Socket Fracture

The normal contour of the shoulder socket gets restored to prevent recurrent instability or dislocations of the shoulder joint. Often times, surgical treatments are considered for the injuries. This is especially true if the fracture consists of a large fragment of the bone or when the fracture is not aligned in position.

Shoulder socket fractures are highly uncommon, making it difficult to ascertain the ideal treatment. However, most surgeons believe that managing the fracture should depend on the patient’s needs and fracture type. You would be asked to undergo physical therapy as well when the fracture heals.

Orthopedic surgeons Dr. Thomas and Dr. Bigler receive patients from Las Vegas, Nevada as well as greater Pahrump, Bullhead City, Lake Havasu, and Mesquite, NV for orthopedic surgery.

Contact Board Certified Surgeons Dr. Bigler or Dr. Thomas at the Knee and Shoulder Institute in Las Vegas, NV to Schedule an Appointment:

If you would like to schedule an appointment or learn more about the Knee and Shoulder Institute procedures & treatments performed by Las Vegas, Nevada board-certified surgeons Steven C. Thomas, MD and Gregory T. Bigler, MD. Contact the office today click here.

Serving patients from and around greater Las Vegas, Lake Havasu, Bullhead City, Mesquite, Pahrump, Nevada

Shoulder Replacement

Shoulder Replacement Surgery

Thousands of traditional total shoulder replacements are carried out every year successfully in the US for patients suffering from shoulder arthritis. However, this type of surgery is not beneficial in patients with large rotator cuff tears, which have caused cuff tear arthropathy.

Conventional total shoulder replacement may not be able to alleviate the pain or increase motion for these patients. In fact, reverse total shoulder replacement is a far better option for these patients.

Thomas & Bigler Knee and Shoulder Institute, led by board certified orthopedic surgeons Dr. Steven C. Thomas and Dr. Gregory T. Bigler, provides orthopedic surgery to patients in Las Vegas, Nevada, while also serving areas such as greater Pahrump, Bullhead City, Lake Havasu, and Mesquite, NV.

How Does Reverse Total Shoulder Replacement Work?

Conventional shoulder replacement devices mimic your shoulder’s normal anatomy. In this type of surgery, a plastic cup like device is fitted to the glenoid or shoulder socket. A metal ball is then attached to the top of the humerus or upper arm bone.

Conversely, in reverse total shoulder replacement, the metal ball and socket are reversed. The plastic cup is fixed to the humerus while the metal ball is attached to the glenoid. This surgical procedure works better on patients with cuff tear arthropathy. This is because it makes use of different muscles for moving the arm.

Rotator cuff muscles in a healthy shoulder help power and position the arm for a wide range of motions. Rotator cuff muscles are used by conventional replacement devices to function properly. Patients with cuff tear arthropathy and large rotator cuff tear do not have these muscles in working order. Reverse total shoulder replacement relies on using the deltoids to position and power the arm instead of the rotator cuff.

Who is a Candidate for the Surgery?

Reverse total shoulder replacement surgery may be recommended in the following scenarios:

  • Cuff tear arthropathy
  • Irreparable or completely torn rotator cuff
  • Second surgery after an unsuccessful shoulder replacement surgery
  • Difficulty lifting the arm
  • Severe shoulder pain
  • Complex shoulder joint fracture
  • Chronic shoulder dislocation

What to Expect During the Pre-operative Stage?

You should wear button-front shirt and loose-fitting clothes on the day of the surgery when you go to the hospital. You may not be able to use your arm extensively since it would be placed in a sling after the surgery. You will be admitted on the surgery day and taken to the preoperative area. This is where you will meet with the anesthesiologist.

You will be given general anesthesia or a regional anesthesia depending on the operation. General anesthetic will help you sleep during the entire operation while regional anesthetic will numb the surgical area. You may be given a combination of the two as well.

Understanding the Surgical Procedure

Shoulder replacement procedure doesn’t take more than two hours. Your surgeon will make a small incision at the top or front of your shoulder and use it to remove the damaged bone. They will then reposition new components for restoring function.

Orthopedic surgeons Dr. Thomas and Dr. Bigler receive patients from Las Vegas, Nevada as well as greater Pahrump, Bullhead City, Lake Havasu, and Mesquite, NV for orthopedic surgery.

Contact Board Certified Surgeons Dr. Bigler or Dr. Thomas at the Knee and Shoulder Institute in Las Vegas, NV to Schedule an Appointment:

If you would like to schedule an appointment or learn more about the Knee and Shoulder Institute procedures & treatments performed by Las Vegas, Nevada board-certified surgeons Steven C. Thomas, MD and Gregory T. Bigler, MD. Contact the office today click here.

Serving patients from and around greater Las Vegas, Lake Havasu, Bullhead City, Mesquite, Pahrump, Nevada

Orthopedic & Sports Medicine Procedures: Revision Joint Replacement

Revision Joint Replacement

Most people who undergo a total knee replacement get back to an active life that is free from the debilitating chronic knee pain. However, in some rare cases, the procedure may fail to yield the expected results. In these types of situations, surgeons recommend a second surgery called a revision knee joint replacement.

The objective of a revision surgery is same as the primary total knee replacement. The technique, though, is more complex because the primary implant will have grown into the bone around the knee and has to be carefully removed. Besides, removal of this prosthesis means some part of the bone is also lost, leaving the surgeon with lesser bone to work on.

Revision knee replacement surgery therefore is a challenging procedure that requires specialized tools and implants along with more detailed planning for the procedure to succeed.

Thomas & Bigler Knee and Shoulder Institute, led by board certified orthopedic surgeons Dr. Steven C. Thomas and Dr. Gregory T. Bigler, provides orthopedic surgery to patients in Las Vegas, Nevada, while also serving areas such as greater Pahrump, Bullhead City, Lake Havasu, and Mesquite, NV.

How Does a Revision Surgery Work?

Revision knee replacement surgery can be of different types. In some patients, the surgeon will revise only one part of the prosthesis; in others, all the three parts – the tibial, femoral, and patellar components have to be replaced along with a rebuilding of the bone around the knee using augments or a bone graft.

If there is significant damage to the bone, the standard knee implants cannot be used for a revision surgery. In cases such as this, the surgeon will use special implants that come with a thicker and longer stem that can fit deeper into the bone to give extra stability and support.

Procedure of Revision Knee Replacement

Revision knee replacement surgery is a very challenging and complex process and may take about 2 to 3 hours time to complete.

The surgeon will first make an incision along the older incision from the primary total knee replacement surgery. The new incision may extend farther in order to allow removal of the old components.

The surgeon then moves in to place the tendons and kneecap aside and reveals the knee joint. They will look for signs of infection in the soft tissues around the knee, and also examine the plastic and metal parts of the prosthesis to check which part has grown loose or worn out or moved out of its intended position.

Any cement that was used in the primary surgery is removed and retaining as much bone as possible, the surgeon will remove the original implant. Next, they will prepare the bone surface to receive the revision implant. Any deficit in the bone around the knee is made up using platform blocks and augments.

In some rare cases, bone grafts may be required to rebuild the knee, and they may be sourced from your own bone or from some donor. Once the bone is adequately prepared, the surgeon inserts the revision implant and any damage to the surrounding soft tissue is repaired before carefully testing the new joint’s movement.

Orthopedic surgeons Dr. Thomas and Dr. Bigler receive patients from Las Vegas, Nevada as well as greater Pahrump, Bullhead City, Lake Havasu, and Mesquite, NV for orthopedic surgery.

Contact Board Certified Surgeons Dr. Bigler or Dr. Thomas at the Knee and Shoulder Institute in Las Vegas, NV to Schedule an Appointment:

If you would like to schedule an appointment or learn more about the Knee and Shoulder Institute procedures & treatments performed by Las Vegas, Nevada board-certified surgeons Steven C. Thomas, MD and Gregory T. Bigler, MD. Contact the office today click here.

Serving patients from and around greater Las Vegas, Lake Havasu, Bullhead City, Mesquite, Pahrump, Nevada

Orthopedic & Sports Medicine Procedures: Hip Replacement

Hip Replacement

Hip replacement surgery is recommended for patients with painful arthritis in the hip joint. In this procedure, the surgeon removes the affected joint and replaces it with a prosthetic one made from plastic and metal components. A successful hip replacement surgery gives the patient relief from pain in the hip and makes walking easier.

Thomas & Bigler Knee and Shoulder Institute, led by board certified orthopedic surgeons Dr. Steven C. Thomas and Dr. Gregory T. Bigler, provides orthopedic surgery to patients in Las Vegas, Nevada, while also serving areas such as greater Pahrump, Bullhead City, Lake Havasu, and Mesquite, NV.

Direct Superior Hip Replacement Technique

Total joint replacement surgery is a field with new technologies evolving at a steady pace. In the field of hip replacement surgery, the latest surgical technique which is minimally invasive is called the Direct Superior Approach.

This newer technique of hip replacement uses an antero-lateral hip approach which is a modified form of the older anterior and posterior techniques. The surgeon makes a single incision in the region near the buttock and works around the muscles surrounding the hip joint.

This results in minimal trauma to the soft tissue in the area. Once the implant is in position, the surgeon repairs the capsule of the hip and the skin to prevent the hip from dislocating, and allow it to heal.

In this approach, the hip does not have to undergo the classical dislocation. This means there is minimal stretching of the capsule, tendons and muscles while removing the femoral head of the joint. As a result, there is less bleeding and also, even less pain than in the other surgical techniques of hip replacement.

Also, because the attachments of the anterior and posterior capsule to the femur are unaffected, the hip stays as perfectly stable as possible. Only one deep muscle structure called the piriformis tendon has to be released during this direct superior technique, and it is easy to repair during the closure.

Patient Benefits From Direct Superior Approach

When a surgeon uses the direct superior approach for hip replacement, it has distinct advantages for the patient such as:

  • Smaller size of incision
  • Lesser damage to the tendon and muscle
  • Decreased blood loss
  • Lower rates of dislocation
  • Lesser possibility of extremity twisting because leg stays in a near-natural position during the surgery
  • Fewer precautions required post-surgery
  • Lower level of pain post-surgery, resulting in reduced usage of pain medication; pain may respond well to mere over-the-counter medication, too
  • Earlier discharge after surgery, even on post-operative first day
  • Lower risk of complication

Precautions to Take Post- Hip Replacement Surgery

Before you are discharged from the hospital, your surgeon will provide you with instructions to make your life easier post-hip replacement surgery. These may include the following:

  • Sit upright in a straight-back, firm chair and do not use recliners.
  • To avoid bending too far and putting pressure on the hips, use a raised toilet seat.
  • Avoid climbing stairs.
  • Keep the floor free of clutter to reduce the possibility of a fall.
  • Refrain from strenuous activities such as physical exercise, driving and sexual activity until your doctor gives you the go-ahead.

Orthopedic surgeons Dr. Thomas and Dr. Bigler receive patients from Las Vegas, Nevada as well as greater Pahrump, Bullhead City, Lake Havasu, and Mesquite, NV for orthopedic surgery.

Contact Board Certified Surgeons Dr. Bigler or Dr. Thomas at the Knee and Shoulder Institute in Las Vegas, NV to Schedule an Appointment:

If you would like to schedule an appointment or learn more about the Knee and Shoulder Institute procedures & treatments performed by Las Vegas, Nevada board-certified surgeons Steven C. Thomas, MD and Gregory T. Bigler, MD. Contact the office today click here.

Serving patients from and around greater Las Vegas, Lake Havasu, Bullhead City, Mesquite, Pahrump, Nevada

Back Pain Specialists

Back Pain Treatment

The spinal column is among the most important and complex systems in the human body. It is the body’s primary support structure and comprises of 33 different bones or vertebrae. These together make up the spinal column and can be divided into cervical, thoracic, lumbar, sacral, and coccygeal.

An intricate knowledge of several different disciplines is required for the medical treatment of spine related diseases and injuries. Most spinal treatment providers focus on pain management, prevention, and function restoration. They are also dedicated to controlling costs for developing back pain treatments.

Thomas & Bigler Knee and Shoulder Institute, led by board certified orthopedic surgeons Dr. Steven C. Thomas and Dr. Gregory T. Bigler, provides orthopedic surgery to patients in Las Vegas, Nevada, while also serving areas such as greater Pahrump, Bullhead City, Lake Havasu, and Mesquite, NV.

Spinal Pain and Epidural Injections

Epidural spinal injections contain steroids, which is directly injected around the nerve root sac, called the dura. This sac contains the cerebrospinal fluid. The injection helps in reducing inflammation that accompanies most spinal issues, like disc herniation, spinal stenosis, and degenerative disc disease.

Inflammatory proteins are flushed out from the spinal structure, that may have been causing pain. Epidural injections go a long way in relieving lower back pain in almost 50% patients. They are beneficial in allowing patients to manage pain in a better way and move towards rehabilitation.

Understanding Minimally Invasive Options for Spinal Surgery

Minimally invasive spinal surgery can help if your chronic back pain doesn’t respond to noninvasive treatments. The procedure is unlike open spine surgery. It combines state of the art technological advances to reduce the incision size and downtime.

More than one spinal condition responds in a positive way to minimally invasive spinal procedure. There are fewer risks associated with the procedure as compared to open spine surgeries.

Understanding Artificial Disc Replacement or ADR

ADR or Artificial Disc Replacement is an alternative option for lower back pain. It is used mainly instead of lumbar fusion since it helps in preserving the normal functioning of the spine. The results of the surgery can vary significantly. Artificial or synthetic disc is used in place of the damaged or worn disc material between the vertebrae.

The procedure is designed to help with chronic back pain while regulating normal motion of the spine. ADR has been performed in the United States with successful results since 2004. There is a 89-97% chance of excellent results in ADR surgery.

Should You Get a Back Surgery?

Back pain is a common occurrence and everybody faces it at some point or the other. However, surgery is not required for every back issue. Your physician should understand the extent of your pain issues and take a call whether surgery is required or not.

Back pain can pass away on its own with rest within a few weeks or months. However, you should still consult a doctor to understand the extent of damage. It is usually better to explore all conservative and non-invasive treatment options before going ahead with surgery.

Orthopedic surgeons Dr. Thomas and Dr. Bigler receive patients from Las Vegas, Nevada as well as greater Pahrump, Bullhead City, Lake Havasu, and Mesquite, NV for orthopedic surgery.

Contact Board Certified Surgeons Dr. Bigler or Dr. Thomas at the Knee and Shoulder Institute in Las Vegas, NV to Schedule an Appointment:

If you would like to schedule an appointment or learn more about the Knee and Shoulder Institute procedures & treatments performed by Las Vegas, Nevada board-certified surgeons Steven C. Thomas, MD and Gregory T. Bigler, MD. Contact the office today click here.

Serving patients from and around greater Las Vegas, Lake Havasu, Bullhead City, Mesquite, Pahrump, Nevada

Orthopedic & Sports Medicine Procedures: Malunion And Nonunion Fracture Treatment

Malunion And Nonunion Fracture Treatment

A fractured bone that takes on an abnormal position during the healing process is called as a malunion fracture. The bone or the limb in which it is present appears to have bent, and its function too gets impaired. A fractured bone that fails to heal even after 9 to 12 months is known as a nonunion fracture.

Both malunion and nonunion type of fractures are complex conditions which are very different from the original fracture. Having such fractures evaluated by an expert surgeon is important to identify the cause so that it can be treated to restore limb function.

Thomas & Bigler Knee and Shoulder Institute, led by board certified orthopedic surgeons Dr. Steven C. Thomas and Dr. Gregory T. Bigler, provides orthopedic surgery to patients in Las Vegas, Nevada, while also serving areas such as greater Pahrump, Bullhead City, Lake Havasu, and Mesquite, NV.

How is Malunion Different From Nonunion?

Malunion refers to a fracture that has healed, but not in the usual position. The healed bone takes up unusual positions which causes the affected limb to get twisted or bent or grow shorter.

In a nonunion, the bone does not heal at all, so realigning does not occur even a year after the fracture. This inability to heal may be due to the body having insufficient bone tissue to repair the break. It may also occur due to other factors such as the patient being a smoker or having diabetes.

Both malunion and nonunion fractures result in similar symptoms of pain, discomfort, bruising, swelling, and impaired function in the affected area. An expert orthopedic surgeon can diagnose the exact condition and treat it using non-surgical or surgical procedures.

Causes of Malunion and Nonunion Fractures

Infection that lingers around the broken bone is one of the causes for a malunion or nonunion, and it can be very challenging to treat. Reconstruction of the bone can start only after completely eliminating the infection.

Insufficient blood supply to the fracture area can lead to dead bone. During the surgery in such cases, the dead bone has to be removed to bring the living bone ends together.

Lack of stability in the affected area may also prevent fracture healing.

The patient’s biology and levels of important substances such as vitamin D, thyroid hormones, and minerals such as phosphorus, calcium and magnesium can also influence the healing process.

Treatment of Malunion and Nonunion Fracture

In some malunion fractures, if the limb function is not reduced, the doctor may advise some non-surgical treatment. In cases where the position of the broken bone is causing further damage, they will advise surgical treatment to remove the aberration. The most common form of surgery for malunion is called an osteotomy and it includes a lengthening, or shortening or realignment of the broken bones.

Nonunion fractures may be treated using braces or electric stimulation while others may require surgery. Surgery for a nonunion fracture involves a repair of the damaged bones and the tissues around them. Gaps in between bones may be filled with a plate and screw system to give stability to the bone. Sometimes, bone grafts are used to stimulate the bones to heal.

Orthopedic surgeons Dr. Thomas and Dr. Bigler receive patients from Las Vegas, Nevada as well as greater Pahrump, Bullhead City, Lake Havasu, and Mesquite, NV for orthopedic surgery.

Contact Board Certified Surgeons Dr. Bigler or Dr. Thomas at the Knee and Shoulder Institute in Las Vegas, NV to Schedule an Appointment:

If you would like to schedule an appointment or learn more about the Knee and Shoulder Institute procedures & treatments performed by Las Vegas, Nevada board-certified surgeons Steven C. Thomas, MD and Gregory T. Bigler, MD. Contact the office today click here.

Serving patients from and around greater Las Vegas, Lake Havasu, Bullhead City, Mesquite, Pahrump, Nevada

Orthopedic & Sports Medicine Procedures: Fracture Treatment

Fracture Treatment

Fracture of the scapula or shoulder blade is common in vehicle collisions and accidents that involve falling from a height. While most such fractures can be treated by non-surgical methods such as the use of a sling and ice and pain medications, surgery may be required in a few rare cases of severe damage.

The scapula is surrounded by a protective covering of several muscles. An injury that fractures this bone is often likely to damage to other adjoining parts such as the collarbone, head, ribs, spinal cord, and lungs.

Thomas & Bigler Knee and Shoulder Institute, led by board certified orthopedic surgeons Dr. Steven C. Thomas and Dr. Gregory T. Bigler, provides orthopedic surgery to patients in Las Vegas, Nevada, while also serving areas such as greater Pahrump, Bullhead City, Lake Havasu, and Mesquite, NV.

Symptoms of Scapular Fracture

Half of the patients who present with a scapula fracture come in with a fracture of the main body of the shoulder bone. About one-fourth of patients show fracture of the neck of the scapula. The common symptoms of a scapular fracture include:

  • Severe pain when you attempt to move the arm
  • Swelling in the area behind the shoulder
  • Scrapes around the damaged area

Once you notice the symptoms of a shoulder blade fracture, it is vital you seek treatment at the earliest to ensure the damage does not increase.

Non-Surgical Modes of Treatment

The most commonly used non-surgical treatment for scapular fracture is a simple sling. This helps to hold the shoulder in place while the bones heal. Within one week, the doctor will advise you to begin mild shoulder movements to avoid stiffness of the shoulder and the elbow.

After you find a reduction in the pain, the surgeon will ask you to remove the sling and start performing passive stretching exercises. Either the surgeon or a physical therapist will guide you with the exercise which you must continue for about six months to one year until your shoulder regains its full range of motion.

Surgery for Scapula Fracture

Scapula fractures that are more complex will require surgery for treatment. Some cases when this is recommended are:

  • Scapular neck fracture accompanied by noticeable angulation
  • Glenoid articular surface fracture with bone displacement
  • Fracture that affects the acromion process, resulting in impingement syndrome

In a scapular surgery, the surgeon first aligns the fragments of the bone into the correct position. Using metal plates and special screws, they attach the fragments together and to the outer surface of the bone. After a period of rehabilitation, the shoulder will regain its normal function.

Pain Management in Scapular Fracture

Scapular fractures cause a significant amount of pain and your surgeon will prescribe pain medications to deal with it. Most doctors advise the use of a combination of NSAIDs, opioids and local anesthetics to combat the pain. This combination helps reduce the dose of the opioids which must be used strictly according to the doctor’s instructions.

To avoid chances of an overdose or dependency, your surgeon will stop your opioid medication after your pain abates. Orthopedic surgeons Dr. Thomas and Dr. Bigler receive patients from Las Vegas, Nevada as well as greater Pahrump, Bullhead City, Lake Havasu, and Mesquite, NV for orthopedic surgery.

Contact Board Certified Surgeons Dr. Bigler or Dr. Thomas at the Knee and Shoulder Institute in Las Vegas, NV to Schedule an Appointment:

If you would like to schedule an appointment or learn more about the Knee and Shoulder Institute procedures & treatments performed by Las Vegas, Nevada board-certified surgeons Steven C. Thomas, MD and Gregory T. Bigler, MD. Contact the office today click here.

Serving patients from and around greater Las Vegas, Lake Havasu, Bullhead City, Mesquite, Pahrump, Nevada.

Contact Us

702.933.9393
9499 West Charleston, Suite 200
Las Vegas, NV 89117