JeffreyB.Witty,M.D.North Oaks Orthopaedic Specialty Center Hammond, LA 70403 Day phone: (985) 230 – 2663 After hours number: (985) 345 - 2700 Fax: (985) 230 – 2665 Website: drjeffreywitty.com

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PostoperativeInstructionsforLabralRepairwithRemplissage:ImportantPhoneNumbers:

- Pleaseseethecontactinformationaboveforimportantphonenumberstocall.

- Ifyouhaveconcernsafterhours,pleasecallthe“Afterhoursnumber”toreachouron-callservices.

PhysicianFollowup:

- Appointmentsforpostsurgeryfollowupcanbemadeoneoftwoways.o Eithercallthedayphonenumberabovetomakeanappointmentwith

thedoctoryourself.o Thenursingstaffatourfacilitycanmaketheappointmentforyouo Thetimetoyourfirstfollowupwillbeconfirmedpriortoleavingfor

theday.o FollowupwithDr.Wittyisabout1weekaftersurgery.

Precautions/Weightbearing:

- Donotplaceanyweightthroughyourshoulderorhand.- TheslingshouldremainonATALLTIMES,includingsleepingwiththe

exceptionofshowersandwhenyoustarttherapytotheshoulder.Sling:

- Pleaserefertothe“YourGuidetoShoulderSurgery”handoutorDr.Witty’swebsiteforinstructionsonslinguseandpositioning.

- Thehandshouldbefacingforwardandtheupperarmshouldbeinlinewiththebodywhenlookingfromtheside.

JeffreyB.Witty,M.D.North Oaks Orthopaedic Specialty Center Hammond, LA 70403 Day phone: (985) 230 – 2663 After hours number: (985) 345 - 2700 Fax: (985) 230 – 2665 Website: drjeffreywitty.com

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Exampleofincorrectpositioningoftheshouldersling.Theupperarmisbehindthetorso/upperbody.

HowtoApplyYourShoulderSling:Note:Pleaseseedrjeffreywitty.comandgoto“PatientInfoandEducation>>PatientEducationVideos”andwatch“HowtoApplyShoulderSling”fordetailsonhowtoapplyyourslingbyyourselfwithoutneedforasecondperson.

JeffreyB.Witty,M.D.North Oaks Orthopaedic Specialty Center Hammond, LA 70403 Day phone: (985) 230 – 2663 After hours number: (985) 345 - 2700 Fax: (985) 230 – 2665 Website: drjeffreywitty.com

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Step1:Placeslingandpillowonsurfaceatleastathipheightandstandnexttoit.Theslingshouldbeopensoyoucanlowertheforearmintothesupport.

Step2:Leanovertowardtheslingwhilesupportinginjuredarmwiththeoppositearm.

Step3:Lowerthearmintothesling.

JeffreyB.Witty,M.D.North Oaks Orthopaedic Specialty Center Hammond, LA 70403 Day phone: (985) 230 – 2663 After hours number: (985) 345 - 2700 Fax: (985) 230 – 2665 Website: drjeffreywitty.com

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Step4:Securethestrapfortheforearmsupportandthestraparoundtheneck.

Step5:Reacharoundbackandgrabthestraptosecurepillowandpassitaroundtothefront.

Step6:Clipthefinalstraptotheappropriatelocationonyourindividualsling.

JeffreyB.Witty,M.D.North Oaks Orthopaedic Specialty Center Hammond, LA 70403 Day phone: (985) 230 – 2663 After hours number: (985) 345 - 2700 Fax: (985) 230 – 2665 Website: drjeffreywitty.com

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NerveBlockInformation:

- Theanesthesiateammayhaveplacedanerveblockpriortosurgery- Anerveblockisaprocedurewherenumbingmedicationisinjectedaround

thenervesthattraveltoyourshoulder.- Itshouldprovide8–12hoursofpainrelief.Duringthattime,theshoulder

mayfeelnumbandyoumayevenbeunabletomovetheextremity.- Starttakingyourpainmedicationimmediatelywhenyoustarttofeelany

painevenifitisminimal.- Monitoryourskincloselyandplaceatowelbetweentheskinandanyice

packtoavoidfrostbite.Thisisimportantwhentheblockisworkingbecauseyouwillnotbeabletofeelanything.

RecoveryatHome:

1) Ifyouaredischargedthedayofsurgery,thefirstmealathomeshouldbeclearliquids.Slowlyincreasetoothereasilytoleratedmeals(ex.Soup)topreventanynausea.Takingyourpainmedicationwithsomefoodmayhelp.

2) Aftershouldersurgery,itiscommonforpatientstofeelmorecomfortablesittinguporinareclinerforatleastafewweeksaftersurgery.Youmayfeelmorecomfortablesleepinginareclinerorsimilarpositionuntilthattime.

3) Ifyouhavereceivedanerveblock(seeNerveBlocksection),itwilloften

begintowearofflaterintheevening.Takethepainmedicationrightwhenyoubegintofeeleventheslightestamountofpaininorderto“getahead”ofthepain.Applyicetohelpwithpain(seesectiononicepacksbelow).

4) Youmaystarttomoveyourelbow,handandwristwhileinthesling.See

exercisesectionbelow.

5) Ifyoubegintohaveworseningpainorswelling,redness,temperaturegreaterthan100.4,ordrainagefromyourincision,callDr.Witty’sofficeimmediatelyatthenumberlistedabove.

6) Trytogetupandmovearoundasmuchaspossibleaftersurgerykeepinginmindanypostoperativeprecautions.

JeffreyB.Witty,M.D.North Oaks Orthopaedic Specialty Center Hammond, LA 70403 Day phone: (985) 230 – 2663 After hours number: (985) 345 - 2700 Fax: (985) 230 – 2665 Website: drjeffreywitty.com

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Ice:

1) Ice(cryotherapy)canbeappliedtotheshoulderimmediatelyaftersurgerytohelpwithpostoperativepainandswelling.Infact,somestudiesshowthaticetreatmentisjustasbeneficialaspainmedication.Commercialcoolertypedevicesattachedtoacuffthatwrapsontheshoulderarehelpful,buticingcanbeperformedusingstandardicepacks.

2) Placeasmallhandtowel(orsimilar)totheshoulderandthenplacethepack/deviceontop.Thiswillhelppreventthedressingfromgettingwetfromcondensation.Itwillalsohelpfromtheskinfrostbiteespeciallywithanerveblock.

3) Applytheicepackasoftenasyouwouldliketohelpminimizepainand

swelling.Becauseyoumaynotbeabletofeelhowcoldtheskinisgetting,pleaseremembertochecktheskinoftenwhilethenerveblockisineffect.Itiscommontousetheicepacksforthefirstfewmonthsaftersurgerywhentheshouldergetssore,especiallyaftertherapy.

WoundCareandDressingChange:

1) Typicallyyourdressingwillconsistofwhitegauzeandwhitetape.Itmayseemalittlebulkyonyourshoulder.Leavethisdressingandtapeonfor3days.Duringthat3-dayperiod,reinforcethedressingifneededwithmoregauzeandtapedirectlyontopoftheinitialpostopdressings.Attheendof3days,youmayremovethetapeandthegauze.Youmayseemorewhitegauze,andunderneaththatyoumayseeyellowgauzeontopofstitches.Youmayremovetheyellowgauze.Replaceclean/freshwhite“4x4”gauzeorsimilardressingsovertheincisionsandre-tape.Seetheimagesbelow.

JeffreyB.Witty,M.D.North Oaks Orthopaedic Specialty Center Hammond, LA 70403 Day phone: (985) 230 – 2663 After hours number: (985) 345 - 2700 Fax: (985) 230 – 2665 Website: drjeffreywitty.com

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2) Anothertypeofdressingusedare“Steri-strips”.Theyaretapelikeadhesives.Theywilltypicallybegintopeeloffontheirownafteraweekorsoandthenyoucanremovethemcompletely.Seeimagebelow.

3) Replacethedressingdailyuntilthedayyouhavenospotsordrainageonthegauze.Youcanuseeithersimilargauzeandtapethatwasinplacerightaftersurgery,oryoucanuseabsorbentadhesivedressingsthataresealedonallfoursides.Seeimagesbelow.

Shower/Bathing:

1) Onceyourincisionshavenodrainage,youmaystarttakingashower.Allowtheoperativearmtohangatthesideandusetheotherarmtobatheanddry.Donotuseyourownarmmusclestoflex(bend)yourelbowatthistime.Itmaybehelpfultoobtainashowerchairwhichwillallowyoutoresttheoperativearmonyourthigh.Seeimagesbelow.

JeffreyB.Witty,M.D.North Oaks Orthopaedic Specialty Center Hammond, LA 70403 Day phone: (985) 230 – 2663 After hours number: (985) 345 - 2700 Fax: (985) 230 – 2665 Website: drjeffreywitty.com

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Step1:Startintheuprightpositionwitharmattheside.

Step2:Leantowardtheinjuredshoulder.Thiswillallowaccesstothearmpitwithoutusingtheshoulderandstressingtherepair.

Note:Thiscanalsobedoneinaseatposition.Leantowardsideasneededtoaccessunderneaththearmforbathing.

JeffreyB.Witty,M.D.North Oaks Orthopaedic Specialty Center Hammond, LA 70403 Day phone: (985) 230 – 2663 After hours number: (985) 345 - 2700 Fax: (985) 230 – 2665 Website: drjeffreywitty.com

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2) Replaceyourslingwithoutmovingyourarmawayfromtheshoulder.Youmayhavetoleantothesidetogentlyallowyourarmtohangawayfromyourbodytoapplythesling.SeeinstructionsaboveorvideoonDr.Witty’swebsite.

Exercises:

- TheonlyexercisesyouwillstartbeforeyoureturntoseeDr.Wittywillbesimplehand,wrist,andelbowmotion.

ElbowActiveFlexionandActiveExtension:- Theslingneedstobeloosenedfortheseexercises.- Opentheslingandallowthearmtofalltothesideandhangfreely.

o - Performabout10–20reps3timesaday.

JeffreyB.Witty,M.D.North Oaks Orthopaedic Specialty Center Hammond, LA 70403 Day phone: (985) 230 – 2663 After hours number: (985) 345 - 2700 Fax: (985) 230 – 2665 Website: drjeffreywitty.com

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WristMotion:- Thearmcanremainintheslingorbedoneoutofthesling.- Simplyextendandflexthewristbackandforthagainstgravity.

o - Performabout10–20reps3timesaday.

HandSqueezes:

- Thesecanbeperformedinoroutofthesling.- Youcanuseanysoftball(tennis,racquetball,etc).Someslingscomewith

theirown.Squeezetheballasmanytimesaspossiblethroughouttheday.