Burners & Stingers

Burners and stingers are common neck or shoulder injuries characterized by intense burning or stinging pain which can radiate from the neck to the hand. They are caused by sudden movement or a direct blow to the neck resulting in an injury to the brachial plexus. This injury is commonly seen in contact sports such as football, ice hockey, wrestling, and rugby. The brachial plexus is a group of nerves which pass from the neck to the arm that transmit the sensory and motor sensations of the arm. The compression or pinching of the brachial plexus results in pain. It usually lasts for a short period of time after which the symptoms resolve. It may also be associated with numbness or weakness of the affected arm. In a few cases it may last for a longer duration of time. People with a narrow spinal canal (spinal stenosis) are at an increased risk of recurrent burners and stingers.

The diagnosis of burners and stingers is usually made on the basis of symptoms and the nature of injury; imaging studies are usually not required. Most of these resolve without any treatment. However, in a few patients the symptoms may persist longer. In such cases as well as in those with recurrent burners and stingers, immediate medical attention is required to check for any other significant injury. Physical therapy can also be considered in these patients.

Athletes should ensure complete recovery from burners and stingers before their return to active sports as the risk of re-injury is very high. Athletes with recurrent burners and stingers are advised to wear a special neck roll or elevated shoulder pads while playing. Spider pads or cowboy collar may also be recommended in a few cases.

Correct use of protective gear and proper sports technique help prevent such injuries.

Clavicle Fracture

Clavicle fracture, also called broken collarbone is a very common sports injury seen in people who are involved in contact sports such as football and martial arts as well as impact sports such as motor racing. A direct blow over the shoulder that may occur during a fall on an outstretched arm or a motor vehicle accident may cause the clavicle bone to break. Broken clavicle may cause difficulty in lifting your arm because of pain, swelling and bruising over the bone.

Broken clavicle bone, usually heals without surgery, but if the bone ends have shifted out of place (displaced) surgery will be recommended. Surgery is performed to align the bone ends and hold them stable during healing. This improves the shoulder strength. Surgery for the fixation of clavicle fractures may be considered in the following circumstances:

• Multiple fractures
• Compound (open) fractures
• Fracture associated with nerve or blood vessel damage and scapula fracture
• Overlapping of the broken ends of bone (shortened clavicle)

Plates and Screws fixation

During this surgical procedure, your surgeon will reposition the broken bone ends into normal position and then uses special screws or metal plates to hold the bone fragments in place. These plates and screws are usually left in the bone. If they cause any irritation, they can be removed after fracture healing is complete.

Pins

Placement of pins may also be considered to hold the fracture in position and the incision required is also smaller. They often cause irritation in the skin at the site of insertion and have to be removed once the fracture heals.

Complications

Patients with diabetes, the elderly individuals and people who make use of tobacco products are at a greater risk of developing complications both during and after the surgery. In addition to the risks that occur with any major surgery, certain specific risks of clavicle fracture surgery include difficulty in bone healing, lung injury and irritation caused by hardware.

Percutaneous elastic intramedullary nailing of the clavicle is a newer and less invasive procedure with lesser complications. It is considered as a safe method for fixation of displaced clavicle fractures in adolescents and athletes as it allows rapid healing and faster return to sports. The procedure is performed under fluoroscopic guidance. It involves a small 1 cm skin incision near the sternoclavicular joint, and then a hole is drilled in the anterior cortex after which an elastic nail is inserted into the medullary canal of the clavicle. Then the nail is passed on to reach the fracture site. A second operation to remove the nail will be performed after 2-3 months.

Other Shoulder List