MUMFORD PROCEDURE - Distal Clavicle Resection

  1. 0
    I got hurt on the job a few months ago. I did PT & Cortisone injections in my shoulder, but I'm still in pain.

    On Friday, I'm having a Mumford procedure performed. The entire surgery will consist of an Arthroscopic Subacromial decompression, distal clavicle resection (they will be taking out a small piece of my clavicle), & a possible repair of a labral tear.

    I read about direct & indirect procedures. It seems that the direct approach has the best outcome. Is that true?

    I'm not an Ortho nurse. Has anyone had this surgery or had patients that had it? How was the outcome? The success rate? ROM post-op?

    Any info will be VERY appreciated. I'm really nervous about getting the surgery, but I'm unable to perform my job now so I don't have a choice. I've been on light duty. I really need to get back on the floor.

    Please respond. Thank you.
    Last edit by ItalianRN on Aug 17, '08 : Reason: typo
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  3. 13 Comments so far...

  4. 0
    it is so funny that ur asking about this specific procedure. i had a pt have it recovered well. i knew it was a shoulder surgery but didn't know details. i researched it and shared with the other ortho nurses on my floor. i know my pts have pain after surgery (expected of course) and go homethe next day on oral narcs (percocet, darvocet usu) you'll be fine. keep it iced or look into a polar care system. they help majorly. better than just a duracold or traditional ice packs.
  5. 0
    Thank you for responding.

    My biggest concern is getting back full ROM. I will definitely buy one of those polar care systems.

    Thanks again.
  6. 0
    I’ve been a critical care/ED nurse for 30 years, and I had a Mumford procedure with shoulder decompression on July 1, 2008. Mine was done arthroscopically, as an outpatient. Here are some things you should consider in making your decision:
    • Recovery time: PT should start about 3 days post-op. ROM returns quickly; but that is not the same as being pain free. Strength is the last to return. Don’t count on going off light duty for at least 6 weeks.
    • Pain: this is an amazingly painful procedure. If you’re offered a brachial plexus (scaline) nerve block as part of the procedure, I’d go with it. You won’t be able to use that arm for 16-24 hours, but you shouldn’t be using it anyway, and it REALLY helps decrease the immediate post-op pain. There are risks to having a block, of course, so talk it over with your gas passer. My doc also prescribed heavy duty narcotics for the first week—I needed them. Ice is your friend, use lots of it.
    • Long term post-op: expect some soreness, especially at night, for 6-8 months. This isn't a surgery you get over in a couple of weeks.
  7. 0
    Quote from knoxvegaswizard
    Recovery time: PT should start about 3 days post-op. ROM returns quickly; but that is not the same as being pain free. Strength is the last to return. Don’t count on going off light duty for at least 6 weeks.
    • Pain: this is an amazingly painful procedure. If you’re offered a brachial plexus (scaline) nerve block as part of the procedure, I’d go with it. You won’t be able to use that arm for 16-24 hours, but you shouldn’t be using it anyway, and it REALLY helps decrease the immediate post-op pain. There are risks to having a block, of course, so talk it over with your gas passer. My doc also prescribed heavy duty narcotics for the first week—I needed them. Ice is your friend, use lots of it.
    • Long term post-op: expect some soreness, especially at night, for 6-8 months. This isn't a surgery you get over in a couple of weeks.

    yup yup yup x 3 everything id she said is tru......not tryingto scare you but alot of doc's seem to leave out this small detail. but as with everything else in life this too shall pass and you'll get thru it. best wishes
  8. 0
    Hi!!
    I had this procedure done 10 days ago. I don't think it is as bad as a lot of people say it is, although everyone is different. I read many forums pre-surgery and was scared out of my wits!!
    I had arthroscopic, with the nerve block (which I would highly recommend), my arm was numb for 24 hours. Yes, there is pain after it wears off, but not unbearable. I was given Percocet and Vistoril to take at home, and didn't have to take them as often as prescribed. Started PT 3 days after, do my exercises 4 times a day at home, ice it after. For me, it is the most painful after PT and exercising. I take it out of the sling a lot, when it gets sore I put it back on. My ROM is already improving and the pain is much less. I'm not saying that it is something I would want to do everyday, but it is not as bad as I thought it would be.
  9. 0
    Thank you for all your replys.

    I had the surgery on Friday 8/22. Had a bad reaction to the anesthesia, vomited for 2 days. Couldn't sleep or eat at all for those 2 days. It was awful. Went to the ER last night & they bolused me with 2 liters of NS, got 4mg of zofran & some pepcid. I told them I didn't want to be admitted so they had me eat some crackers & drink some water before discharging me. Thank God that did the trick. They also sent me home with a script for zofran which I took last night & another one this morning. No more vomiting. YEAH!! Had a lot of pain last night but wouldn't take anything for fear of vomiting again.

    Today wasn't bad. My friend took me home today so now I'm on my own with my dog.

    I'm not sure how long I'm supposed to use the cyro machine they sent me home with. It's hard for me to manage it by myself. I have my first post-op appt. tomorrow.

    I feel very tired but I'm sure that's because the past few days were pretty stressful on my body. I'll write more after my doctor visit tomorrow.

    Thanks for the advice. It's helpful. It's also nice to know there are nurses out there that have had this & are still performing their jobs. By the way, my MD didn't order PT post-op 3 days. I'll talk to him about that tomorrow. Thanks again.
  10. 0
    I had the posterior and inferior labral repair (HUGE tear 3 o'clock round to 11 o'clock,) but not the other. I had requested overnight observation due to having just rec'd a pacemaker and the fact I lived over an hour away. The insurance Co. approved it. The procedure was fine and I only needed a few PT sessions.

    My biggest problem was nausea and vomiting and I took virtually no pain med after getting home. They gave me PO Phenergan which was NO help for the nausea. The pendulum exercises seemed to bring it on .

    Plus I couldn't lie on my pacemaker side and I couldn't lie on my operative shoulder. Bummers. Good luck to you , I hope you heal well.
  11. 0
    i would use the cryo machine as much as possible. comparing the difference between my ortho pts whoi use them to those that just just an ice bag or nothing at all is a vast difference. helps with swelling and pain. def find out about PT. i dont know anyone personally that work in the hosp that had a mumfordm but i do know several that had their rotator cuff repaired or a total shoulder replacement done and they all have full ROM back and are pain free working. ones even a man whos a transporter who lifts and pulls all day long. he did PT as an outpatient. he said hes back 100%. hope you feel better. yea i couldnt even imagine how badly it hurt to vomit with a shoulder immobilized and in pain. u poor thing. hope this gives u some peice of mind also. i myself am in a lot of pain. got into a major car accident on wednesday afternoon on my way back from a restful day on the beach. some young chick blew thru a stop sign( says she didn't see it and wasn't familiar with the neighborhood) i ended up T-boning her passenger side of her car and totalled my car. ok just bruised, on my knees where the steering collumn got pushed back inot my knees; got a burn on my inner arms from the airbags (now its gone used silvadene and ice immediately) and whip lash. but if u saw my care u would be shoked that thats all i got. and it was only a block from my house. stinks
  12. 0
    Well, I'm 8 days post-op & feeling better. I only wear the sling when I go outside.

    I think my PT is going well & I've been doing my exercises at home. I think I may have over done it a little today because my arm / shoulder started hurting a little more than usual.

    Still not driving, until I get the ok from my doc & I'm still not holding anything in my right hand.

    I am very surprised how well I'm doing (I'm a little biased). LOL!!

    Can't wait to regain my full ROM!! I'm so anxiou to drive again too!!!


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