Needing A Shoulder to Rely Upon

News Archive (2010)

Needing A Shoulder to Rely Upon.

Needing A Shoulder to Rely Upon

Unlike Moore, who didn't have to look for a trauma surgeon, finding the right doctor was important for Flagstaff resident Daniel Smith, who came to John C. Lincoln Deer Valley Hospital for innovative shoulder surgery.>

And his shoulders needed serious help. Working on the railroad will take its toll, even on the toughest men. During his 30 years with the Santa Fe and later the B&N Santa Fe Railroad, Smith had five surgeries to repair damage to his right shoulder – and four on his left.

"It was putting the trains together, putting on the cars," he said. "I worked in the rail yard for over 17 years and that's a lot of wear and tear."

Smith's most recent surgical solution — something radically different — started a year ago when surgeons at Flagstaff Medical Center repaired a torn chest muscle. But a few months ago, it was clear that the repair hadn't solved the problem.

"They told me I needed a 'reverse' shoulder repair, but they were hesitant to do it because they didn't have the experience. So they referred me to Dr. Wall at Deer Valley Hospital," Smith said.

The Specialized Answer: Reverse Shoulder Arthroplasty

According to Bryan Wall, MD, who is part of The CORE Institute and operates on patients at Deer Valley, reverse shoulder arthroplasty — one of his specialties — has only been available in this country for a half-dozen years and not many surgeons are doing it.

In traditional shoulder surgery, the ball at the top of the arm bone is replaced with a metal ball and the shoulder blade socket is replaced with a plastic socket. The reverse repair also uses a ball-and-socket joint, but the ball is attached to the shoulder blade, and the socket is grafted to the top of the arm bone, reversing and reconstructing normal anatomy.

The reverse procedure was specifically designed for patients such as Smith who have had traditional shoulder surgery complicated by shoulder arthritis and a torn rotator cuff. The rotator cuff is a group of four tendons and muscles that surround the shoulder joint. In these patients, the traditional artificial shoulder socket may loosen, causing excruciating pain.

Smith came to Deer Valley on March 18 where Dr. Wall had to break the artificial ball from the top of his arm to rebuild his joint.

"This is the first broken bone I've had in my whole life," Smith said, "and after two months, it's still a bit sore. But it's nothing compared to the pain I had been living with, and the difference is that I know this pain is going away. I really thank Dr. Wall for his work."

Healing is extra important now, because Smith's wife and daughter are nurses at Flagstaff Medical Center, which means his job is at home caring for his grandchildren, 4-year-old Jaylee Rose and baby Zach. "I've always been good with kids, cousins, nephews or others," he said, "so this is good. But I have to heal. Babies get heavy!"

The "Carpenters of Medicine"

Being able to solve Smith's problem is the kind of thing that initially appealed to Dr. Wall during his medical training. "I was attracted to orthopedics and specifically to shoulder work during my residency because it is so concrete, something that can be fixed. I like a problem I can solve," Dr. Wall observed.

Dr. Wall worked his way through college as a carpenter. "There are a lot of similarities to what I do now," he mused. "You could say that orthopedic surgeons are the carpenters of medicine."