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Dr. Mark can you help me with failed 3rd degree seperated shoulder

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so would a bone have grown back since or would i have to have some bone graph put in? seeing that you said about 3 months i would be back to actiivties when would i not have to worry about it? like i would be worried if and when i got my motion back then working out i woudl somehow pop have it screw up again.

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i just wanted to update you. i am having issues with getting the funds, but i will. if i could do it tomorrow i would be there shaking your hand ready to go.

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Dr. Sanders, what method of fixation do you use for these? Is your technique any different for primaries vs revisions?

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I have a very simple techinique that always works, for primary cases, and most revisions assuming that the guy isn't a smoker.

I remove the distal one centimeter of the clavicle.

I put two #5 fiberwire suturs under the coracoid, pass them through drill holes in the clavicle in the anatomic location of the conoid and trapazoid ligaments, and tie the sutures over a plastic button.

I allow immediate use of the arm for ordinary activity with no sling or immobilization.

Return to sports at about 2-3 months.

Simple, reporducable, cheap. The essence of the K.I.S.S. principle

Keep it simple, stupid.

If you want to be the first one on the block to have a fancy new operation that involves several thousand bucks worth of dead person's tendons and unproven hardware that won't work, don't look at me. (look at the first page of this post and that nasty X-ray)

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Would you do the same for chronic cases? Does the capsule and ligaments scar in or are you depending on the fiberwire to be the permanent restraint?

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No implant can ever be a permanant restraint. All implants fail in time, not backed up by living tissue.

The body lays down dense scar tissue between the coracoid and the undersurface of the clavicle. What is a ligamemt? Organized, dense scar tissue, at least in my opinon. Sometimes the space even ossifies. Then it is really tight.

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just wanted to update that i have had yet another misfortune in my life(fire) but i still plan on seeing you. hopefully in the next month or two.

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No implant can ever be a permanant restraint. All implants fail in time, not backed up by living tissue.

The body lays down dense scar tissue between the coracoid and the undersurface of the clavicle. What is a ligamemt? Organized, dense scar tissue, at least in my opinon. Sometimes the space even ossifies. Then it is really tight.

Do you "rough up" those two areas to encourage the formation of dense scar tissue or does it happen naturally through abrasion/contact/friction? This is the part of the repair that I have never understood.

Thanks

Also, is it typical for say NC Blue Cross to pay for surgery in Houston? I have had a 3rd degree for about 5 years that I am tempted to fix.

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Just getting in and out "roughs up" the tissue enough to stimulate healing in a nonsmoker.

Providership for BC/BS is national. I am "in network" for someone from NC.

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Things are starting to come together. I was wondering when I set up an appointment how should i arrange traveling? is that something i have to do or is there a program that sets me up?

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Just thought I'd add my two cents on this matter.

Its about to be 2 years since my 3rd degree separation. What a crappy injury eh? Really wish I just broke my collar bone and was done with it, seems like a straightforward injury compared to ours. I went to several of the "best" doctors in nyc and long island who works on "pro atheletes" and I never feel very optimistic when leaving their office. If the doc doesnt feel confident in their method of repair then why should I?

Anyways, Dr. Mark is the only doctor that seems to know what he's doing. He took the time to speak to me directly via cell phone. Hes a pleasure to speak with and is confident in his procedure. At the time, his office didnt take my insurance, but now I have insurance which they do take. Im trying to just strengthen it and avoid surgery but if I ever change my mind, i WILL be on a plane to Houston. I hear everyone tell me "were in the medical mecca of the world (nyc), surely you can find a doc whos atleast as good as dr mark all the way in houston".

Well this is my body and being able to get the "best" doctor in NY isnt worth having a F'd up shoulder repair.

When the doc in NY seem more apprehensive about repairing your body than you are about hittin a 90 ft triple for the first time, something aint right.

Good luck with your shoulder.

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my plan is to see the good doctor cause he has me very confident i could be fixed. i have had several things holding me back (my insurance only covers me for pa) and i had a recent fire that took everything i owned away from me. i push forward thou knowing that i will have this fixed and that i could add texas to the states i have been too. haha

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I tried contact that email address to get the cost for shipping so I could get a total on everything and I got a message sayingmialing address was invalid. right now i need a complete figure to go out there and get this done and come back.

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I was on some medicine last night when i posted that last message. What I meant to say was I tried contacting that email address you provide to see how much traveling arrangements would be. I am in a much better situation right now and am looking to get this done soon. I would like to see what everything going to be so i could get everything ready to go.

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