Surgery to Repair Shoulder Joint Fractures
By Tim Crytser
Courtesy of St. Vincent's Health Care in Jacksonville, FL 
 
 
 
 
 

The Asterisk Mobile Medic unit has come a long way since 2000 when Dr. Steve Augustine and Dr. John Bodnar would literally show up at the races with their medical bag in hand.  Since then, the operation has grown to become a complete on-site medical program that everyone in the industry has come to know and trust.  When Dr. Augustine isn't traveling the National circuit, his day job is at the Jacksonville Orthopedic Institute Riverside Division in association with St. Vincent’s Hospital in Jacksonville, FL.  He grew up in Cleveland, Ohio and in 1990 graduated from Denison University in Granville, Ohio and earned his Osteopathic Medical Degree from Ohio University in Athens, Ohio.  Once he completed his orthopedic surgery residency at The Philadelphia College of Osteopathic Medicine, he sub-specialized in two areas; one in sports medicine/arthroscopy and one in shoulder reconstruction. He works as the physician advisor to the Road 2 Recovery Foundation and has been providing medical coverage for the AMA Supercross and Motocross series since 2001. He is also a founding member of the AMA medical advisory board and enjoys participating in all action sports particularly  motocross, as  well as jet skiing, wake  boarding, snow boarding and  mountain  biking. That's  all we really know  about  the guy. - Virtual trainer

The Shoulder Nail Plate

If you race, hopefully this is the only time you will see Dr. Augustine's face!

It's been called the unsolved fracture. That's because there hasn't been an ideal way to repair a badly broken shoulder joint. But Dr. Stephen Augustine, an orthopedic surgeon at St. Vincent's Medical Center, is using a new device and technique that comes close. The shoulder nail plate system solves the technical problem of pulling the broken pieces of bone back together, and since this system is less traumatic to the surrounding muscles, it offers a quicker recovery and may restore more function than typically gained with other methods.
 
About 5 percent of all fractures are shoulder joint fractures. They can occur in traumatic accidents, but they usually happen as a result of a fall. Falling on the shoulder can break off the ball part of the humerus, or upper arm bone, which fits into the shoulder socket. You usually end up with three or four pieces that are displaced by the pull of the tendons and the muscles, and you have to put the puzzle back together for it to heal, says Dr. Augustine. This requires anything from pins and sutures to this new device, called a shoulder nail plate.

Inventing a Better Wheel
Traditional repair methods are plagued by potential problems. Nothing really seemed to be the answer, Dr. Augustine says. Just moving the shoulder can cause pins used to hold the pieces of bone together to dislocate and become infected. Sometimes the joint doesn't heal well, and fixation with external pins can be so painful that patients can't move the joint for four-to-six weeks.  The shoulder joint permits the widest range of movement than any other joint in the body and falls and motorcycle accidents are the two major causes of this type of fracture.