Frank B. Norberg, MD

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Patient Education

Guidebooks

Our guidebooks contain everything you need to know about the specific procedures we perform. Please read through these as they answer most common questions.

The Clavicle Fracture Book
The clavicle is also known as the collarbone. Clavicle fractures occur after trauma, falling directly on the shoulder or outstretched arm. A majority of clavicle fractures are in the middle (75 percent – 80 percent). Not all clavicle fractures need to be fixed surgically. The need for surgical fixation is dependent on the risk of the bone segments not healing (nonunion) or being positioned poorly. All of those factors are taken into consideration when being assessed after an injury. If your injury requires surgery, there are many techniques used to fix clavicle fractures based on the type of fracture. The technique chosen will be tailored to you and take into consideration many factors. Dr. Frank Norberg has been fixing clavicle fractures for more than 20 years.

The Proximal Humerus Fracture Book
The shoulder is a ball and socket joint and made up of three bones: the upper arm bone (humerus), shoulder blade (scapula), and collar bone. The humerus has a ball attached to it called the humeral head. Fractures of the humerus most commonly occur with trauma such as falls and vehicle/bicycle accidents. There are many types of proximal humerus fractures. The majority of humeral head fractures do not require surgical fixation. In the cases that surgical fixation is needed, a plate and multiple screws will typically be used to align and secure the fracture to allow it to heal. If the ball and socket are also damaged during the fracture, a shoulder replacement may be indicated. Dr. Norberg specializes in surgical fixation of proximal humerus fractures and uses the most current methods for optimal outcomes.

The Reverse Shoulder Replacement Book
Shoulder arthroplasty (replacement) is used in the presence of severe arthritis in the shoulder. There are two different kinds of shoulder replacements: a reverse shoulder replacement and standard shoulder replacement. The shoulder is composed of a (ball) humeral head and a (socket) glenoid. Four muscles and their tendons (rotator cuff) work to keep the humeral head centered on the glenoid. Articular cartilage covers the ends of the humeral head and the glenoid. With age, heredity, rheumatologic disorders and chronic rotator cuff or labrum tears, the articular cartilage of the shoulder will wear away and become arthritic. Symptoms include: pain, loss of motion, loss of strength, loss of function, joint swelling, and pain at night. If the rotator cuff is intact in the presence of arthritis a standard replacement can be performed. If arthritis is severe enough and the rotator cuff is not intact, a reverse shoulder replacement can be performed. Dr. Norberg specializes in shoulder replacement techniques and, in cases with severe arthritis, will use custom computing software combined with a CT scan to align the implants into an optimized position for the most favorable outcomes.

The Rotator Cuff Repair Book
The rotator cuff is a group of four dynamic muscles and their tendons that stabilize the shoulder. Tears of the rotator cuff tendon can occur with direct injury or repetitive stress. The tendons undergo degenerative changes over time, leading to a higher rate of rotator cuff tears in an older population. Rotator cuff tears have a low rate of healing without surgery, which is also based on other factors such as the size of the tear. Symptoms can vary but typically include pain, shoulder weakness, difficulty sleeping. After clinical examination, a potential rotator cuff tear will need an MRI for further planning. In the presence of significant arthritis or in the absence of repairable cuff you may be a candidate for superior capsular reconstruction or standard/reverse shoulder replacement. Dr. Frank Norberg specializes in rotator cuff repairs and uses the most current surgical techniques for best outcomes.

The Shoulder Instability Book
The shoulder is a dynamic joint capable of large amounts of motion. It relies on the rotator cuff muscles, capsule that surrounds the joint, and the labrum for stability. These components of the shoulder work together to provide stability. Damage to one or more of these structures will put the joint at risk for subluxation or dislocation. Dislocation and subluxation can happen with or without trauma, depending on your predisposed anatomy. Dislocations and subluxations at an early age can predispose the shoulder to early arthritis and functional impairment. Instability is almost always repaired. Dr. Norberg specializes in arthroscopic repair of the labrum, capsule and socket fractures for athletes and non-athletes, using the most current methods that favor the best surgical outcomes.

The Shoulder Replacement Book
Shoulder arthroplasty (replacement) is used in the presence of severe arthritis in the shoulder. There are two different kinds of shoulder replacements: a reverse shoulder replacement and standard shoulder replacement. The shoulder is composed of a (ball) humeral head and a (socket) glenoid. Four muscles and their tendons (rotator cuff) work to keep the humeral head centered on the glenoid. Articular cartilage covers the ends of the humeral head and the glenoid. With age, heredity, rheumatologic disorders and chronic rotator cuff or labrum tears, the articular cartilage of the shoulder will wear away and become arthritic. Symptoms include: pain, loss of motion, loss of strength, loss of function, joint swelling, and pain at night. If the rotator cuff is intact in the presence of arthritis a standard replacement can be performed. If arthritis is severe enough and the rotator cuff is not intact, a reverse shoulder replacement can be performed. Dr. Norberg specializes in shoulder replacement techniques and, in cases with severe arthritis, will use custom computing software combined with a CT scan to align the implants into an optimized position for the most favorable outcomes.

The Superior Capsular Reconstruction Book
The rotator cuff is a group of four dynamic muscles and their tendons that stabilize the shoulder. Tears of the rotator cuff can vary in size and over time can become irreparable. Without the superior rotator cuff muscle, your shoulder will rise while lifting your arm. This is referred to as superior humeral head migration and can lead to arthritis. This is typically associated with pain and decreased function of the shoulder. Irreparable rotator cuff tears are diagnosed using an MRI and arthroscopically. In the past, irreparable rotator cuff tears were treated with a partial repair or a reverse shoulder replacement. In order to prevent arthritis and return function without replacing the shoulder, Dr. Norberg performs a procedure that replaces the area of irreparable rotator cuff with a strong graft to help restore normal shoulder mechanics. All repairable portions of the rotator cuff are integrated into the graft in an attempt to restore superior rotator cuff strength. Dr. Norberg specializes in this technique which has only been performed in the United States since 2014.

The Tennex (Tennis Elbow) Book 
Tendinopathy (tendinitis or tendinosis) is the most common condition affecting the elbow. It is referred to as tennis elbow when it affects the lateral (outside) elbow and golfer’s elbow when it affects the medial (inside) elbow. It is known as patellar tendinosis (jumper’s knee) when it involves the knee. Elbow tendinopathy can be caused by sports such as golf and tennis as well as work-related activities that involve heavy use of the wrist and forearm such as painting. Jumpers knee is one of the more common tendinopathies affecting athletes with mature skeletons. It occurs in up to 20 percent of jumping athletes (basketball, volleyball, long/high jumping). It involves repetitive stress placed on the patellar tendon in the front of the knee. Steroid injections used to be the staple treatment, but research has shown that most patients have poor long-term outcomes due to the effects of the steroid on ligament healing. A new treatment has been developed using an ultrasonic needle to debride (clean up) the damaged portion of the tendon. This procedure is less invasive and shows comparable outcomes to arthroscopy. Dr. Norberg specializes in treatment of tendinosis and utilizes this technique to treat these conditions.

Shoulder & Elbow

Knee

General

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Rehabilitation Protocols

Anterior Shoulder Reconstruction
Biceps Tenodesis Without Rotator Cuff Repair
Knee Arthroscopy
Massive Rotator Cuff Repair
Posterior Shoulder Reconstruction
Reverse Shoulder Arthroplasty
Shoulder Arthroscopy Subacromial Decompression & Distal Clavicle Excision
SLAP Lesion Repair
Standard Rotator Cuff Repair
Superior Capsular Reconstruction
Total Shoulder Arthroplasty