Shoulder Specialist Surgeon in Kochi

Shoulder and Upper Limb Surgery

Doctors
Treatment and Facilities
Surgical Treatments
Other procedures
Facilities

Shoulder and Upper Limb Surgery

Sunrise Hospitals Shoulder and Upperlimb Unit offers a wide range of procedures including arthroscopy (keyhole surgery), joint replacement and trauma reconstruction on the shoulder, elbow, wrist, hand and finger. Our expert surgeons perform these operations using minimally-invasive techniques wherever possible, allowing our patients to resume normal movement and activity quickly and comfortably.

Doctors

Dr. Prathap Kumar KR

Consultant Shoulder & Upper Limb Surgeon

Best Shoulder & Upperlimb Surgeon in Kochi

Treatment and Facilities

Shoulder & Elbow

- Fracture surgery

- Total shoulder replacement

- Reverse shoulder replacement

- Shoulder arthroscopy

- Rotator cuff repair

- Surgery for tennis elbow

- Elbow arthroscopy

Wrist & Hand

- Fracture surgery

- Carpal tunnel release

- Wrist arthroscopy

- Wrist joint replacement

- Wrist fusion

Shoulder arthroscopy is a type of keyhole surgery that is used to look inside and treat damage to your shoulder caused by an injury, arthritis or certain health conditions. Because the arthroscope and surgical instruments are thin, surgeon can use very small incisions (cuts), rather than the larger incisions needed for standard, open surgery. This results in less pain for patients and shortens the time it takes to recover and return to routine activities.

Injury, overuse, and age-related wear and tear are responsible for most shoulder problems. Shoulder arthroscopy may relieve painful symptoms of many problems that damage the rotator cuff tendons, labrum, articular cartilage, and other soft tissues surrounding the joint.

Common arthroscopic (keyhole) procedures include:

-Rotator cuff repair

-Removal or repair of the labrum

-Repair of ligaments

-Removal of inflamed tissue or loose cartilage

-Repair for recurrent shoulder dislocation

Less common procedures such as nerve release, fracture repair, and cyst excision can also be performed using an arthroscope. Some surgical procedures, such as shoulder replacement, still require open surgery with more extensive incisions.

Joint Replacement for Shoulder, Elbow and Small Joints of Hand

Shoulder Joint Replacement - Total shoulder replacement, also known as total shoulder arthroplasty, is the removal of portions of the shoulder joint, which are replaced with artificial implants to reduce pain and restore range of rotation and mobility. It is very successful for treating the severe pain and stiffness caused by end-stage arthritis.

Elbow Joint Replacement - During elbow replacement, a surgeon replaces your elbow with an artificial joint made from two implants that attach to the bones in your arm. A metal and plastic hinge joins the implants together. The procedure is similar to hip and knee replacements. You want a surgeon who has a lot of experience.

In a joint replacement, the abnormal bone and lining structures of the joint are removed surgically, and new parts are inserted in their places. These new parts may be made of special metal or plastic or specific kinds of carbon-coated implants. The new parts allow the joints to move again with little or no pain.

Rheumatoid arthritis causes inflammation and destruction of the cartilage in the joints of the wrist and hand, leading to pain, swelling, and deformity. Rheumatoid arthritis can also lead to swelling of the ligaments and tendons, causing instability and deformation of the joints.

The classic features of rheumatoid arthritis include nodules along the fingers or elbow, angulation or collapse of the fingers, inability to straighten the finger due to tendon rupture, and prominence or collapse of the wrist bones.

The treatment of rheumatoid arthritis focuses on decreasing the inflammation, reducing pain, and restoring function. Optimum treatment involves a team approach, including the patient's primary care physician, a rheumatologist, a hand surgeon, and therapists.

The surgical treatments for RA of the hand and wrist include synovectomy, tenosynovectomy, tendon realignment, reconstructive surgery or arthroplasty, and arthrodesis. Surgical treatment is much more likely to be successful if it is implemented early in the course of the deformity.

Congenital deformities of the upper limbs are complex conditions that include transverse deficiencies, longitudinal deficiencies of the forearm, and deficiencies of the hands and fingers. They are classified into two types ie Congenital Deformities and Acquired Deformities

- Congenital Deformities

The causes of some birth defects can be difficult or impossible to identify. However, certain behaviors greatly increase the risk of birth defects. These include smoking, using illegal drugs, and drinking alcohol while pregnant. Other factors, such as exposure to toxic chemicals or viruses, also increase risk.

- Acquired Deformities

An acquired deformity is a change in the normal size or shape of a body part as a result of an injury, infection, arthritis, or tumor.Common causes of acquired deformities include misaligned broken bones, osteoarthritis (a disease that causes the joints to degenerate), and conditions like cancer and thyroid disease that cause tumors, goiters, or other masses to form. Some acquired deformities may be visible, but many are not.

-Scapula (Shoulder Blade)

The shoulder blade (scapula) is a triangular-shaped bone that is protected by a complex system of surrounding muscles.The most common symptoms of a scapula fracture includes extreme pain when you move the arm, swelling around the back of the shoulder and scrapes around the affected area.

Treatment of Scapula Fractures:

Non Surgical Treatment - Nonsurgical treatment with a simple sling works for most fractures of the scapula. The sling holds your shoulder in place while the bone heals. Your doctor may want you to start moving your shoulder within the first week after the injury to minimize the risk of shoulder and elbow stiffness.

Surgical Treatment - Scapular fractures may require surgery if fractures of the glenoid articular surface in which bone has moved out of place (displaced), fractures of the neck of the scapula with a lot of angulation, fractures of the acromion process that cause the arm bone to hit against it (impingement syndrome). During surgery, the bone fragments are first repositioned (reduced) in their normal alignment, and then held together by attaching metal plates with special screws to the outer surface of the bone.

Pain after an injury or surgery is a natural part of the healing process. Your doctor will work to reduce your pain, which can help you recover faster.

Surgical Treatments

Anterior stabilization or Bankart Repair is a procedure to prevent recurring anterior shoulder dislocations due to instability in the back (anterior) of the shoulder. Arthroscopic (Keyhole Surgery) Bankart repair results in minimal pain and trauma and less scarring and damage to surrounding tissue than traditional open surgery. There is also a shorter recovery period and a shorter length of rehabilitation than with traditional open surgery. After arthroscopic Bankart repair, patients will generally be required to keep their arm immobilized in a sling for approximately one month. However, physical therapy will begin on or about day 5 following surgery.

The term SLAP is an acronym for Superior Labrum Anterior and Posterior. A (SLAP) tear occurs in the top (superior), the front (anterior) and back (posterior) of the point where the biceps tendon attaches to the labrum. Common causes of SLAP tear can occur from trauma or overuse. Athletes involved in sports that require repetitive overhead activities are particularly vulnerable to develop this condition. In addition, motor vehicle accidents, falling on an outstretched arm, or forceful pulling on the arm can cause a labral tear. Surgicaly SLAP repair is a minimally invasive arthroscopic (Keyhole) procedure which uses a tiny camera and miniature surgical instruments to repair the damaged area. During the procedure, your surgeon will remove damaged tissue and suture the torn labrum to a tiny anchor set into the bone.

Tenodesis is a surgical procedure that is typically used to treat injuries to the biceps tendon in the shoulder. These injuries may occur due to tendonitis, an inflammation of a tendon, or from overuse or a trauma / accident to the shoulder area. Biceps tendon is surgically treated through a minimally invasive surgery in which the surgeon cuts the biceps tendon from the glenoid and reattaches it to the humerus using sutures and screws. This procedure is more often done with younger and more active patients because it is considered to be more stable, and it carries less chance of a Popeye deformity. People tend to recover more quickly from biceps tenotomy and have a lower risk of surgical complications like infection.

Capsular release is keyhole surgery involving the release of the tight capsule seen in 'frozen shoulder'. Frozen shoulder is a painful condition in which the shoulder becomes 'stuck'. It often starts for no reason, but may be triggered by a mild injury to the shoulder. Arthroscopic (Keyhole) surgical capsular release of your frozen shoulder normally takes one to two hours to complete. You will be put under general anesthesia, and you may also be given an interscalene block, which is a regional anesthetic that is administered through an injection in your neck and numbs your shoulder area.

Rotator cuff injuries are common and increase with age. These may occur earlier in people who have jobs that require repeatedly performing overhead motions like painters and carpenters.

The most common symptoms are pain at rest and at night, particularly if lying on the affected shoulder, pain when lifting and lowering your arm or with specific movements, weakness when lifting or rotating your arm and crackling sensation when moving your shoulder in certain positions. Rotator Cuff is surgically treated through Arthroscopic (Keyhole) tendon repair. In this procedure, surgeons insert a tiny camera (arthroscope) and tools through small incisions to reattach the torn tendon to the bone.

Subacromial decompression is an operation on your shoulder which treats a condition called shoulder impingement, where you feel pain when you raise your arm. Subacromial decompression is a minimally invasive arthroscopic procedure to treat subacromial impingement syndrome. The surgery aims to increase the size of the subacromial area and reduce the pressure on the muscle. It involves cutting the ligament and shaving away the bone spur on the acromion bone. This allows the muscle to heal. The length of recovery from a subacromial decompression procedure will usually be 1-2 months. However, the sling will be discontinued after a few days to reduce the risk of postoperative stiffness.

The AC joint is injured most often when one falls directly on the point of the shoulder. The trauma will separate the acromion away from the clavicle, causing a sprain or a true AC joint dislocation. In a mild injury, the ligaments which support the AC joint are simply stretched, but with more severe injury, the ligaments can partially tear or completely tear. In the most severe injury, the end of the clavicle protrudes beneath the skin and is visible as a prominent bump. Surgical Treatment is done through Shoulder resection arthroplasty (keyhole). The procedure is usually performed by making a small 2 in (5 cm) incision in the skin over the AC joint. In some cases, the surgery can be done arthroscopically. In this approach, the surgeon uses an endoscope to look through a small hole into the shoulder joint. The endoscope is an instrument of the size of a pen, consisting of a tube fitted with a light and a miniature video camera, which transmits an image of the joint interior to a television monitor. The surgeon proceeds to remove the segment of collarbone through a small incision with little disruption of the other shoulder structures.

Other procedures

Shoulder Resurfacing as an orthopedic procedure that is used as an alternative to total shoulder replacement surgery. Instead of replacing the entire shoulder joint, shoulder resurfacing involves “smoothing out” the spot where the upper arm bone (humerus) and shoulder blade (scapula) meet (the glenohumeral joint). Shoulder Resurfacing may be ideal for those who need help alleviating pain and increasing mobility, but don't need a total replacement yet. Resurfacing can be used in patients with mild to moderate arthritis that is confined to the humeral head. It can be ideal for people experiencing osteoarthritis, rheumatoid arthritis, avascular necrosis, rotator cuff disease or injury, and post trauma arthritis. Patients who receive shoulder resurfacing usually stay in the hospital one to two days. On the second day, the bandages are removed and limited exercise is started to facilitate recovery. A sling must be worn for up to six weeks and a few weeks of exercises at home are needed to restore motion to the joint.

Total shoulder replacement (also called total shoulder arthroplasty) is a surgical solution for shoulder pain that involves replacing arthritic joint surfaces and damaged bone with artificial devices.

Shoulder replacement surgery is usually recommended for people who have severe pain in their shoulder and have found little or no relief from more conservative treatments.

Some conditions that may require a shoulder replacement include:

*Osteoarthritis. This type of arthritis is common in older people. It occurs when the cartilage that pads bones wears away.

*Rheumatoid arthritis (RA). With RA, your immune system mistakenly attacks your joints, causing pain and inflammation.

*Avascular necrosis. This condition happens when loss of blood to a bone occurs. It can cause damage and pain in the shoulder joint.

*A broken shoulder. If you badly break your shoulder bone, you might need a shoulder replacement to repair it.

You can expect to spend 2 to 5 days in the hospital after your operation before going home.

It's a major surgery that'll keep you in the hospital for several days. You’ll also need several weeks of physical therapy afterward.

The major difference between a standard shoulder replacement and a reverse procedure is that in a reverse shoulder replacement the ball and socket parts of the shoulder joint switch sides. This means their natural position is reversed.

Reverse total shoulder replacement may be recommended for patients with the following

*A completely torn rotator cuff that cannot be repaired

*Cuff tear arthropathy

*A previous shoulder replacement that was unsuccessful

*Severe shoulder pain and difficulty lifting your arm away from your side or over your head

*A complex fracture of the shoulder joint

*A chronic shoulder dislocation

*A tumor of the shoulder joint

*Tried other treatments, such as rest, medications, cortisone injections, and physical therapy, that have not relieved shoulder pain

This procedure to replace your shoulder joint with an artificial device usually takes about 2 hours. Your surgeon will make an incision either on the front or the top of your shoulder and remove the damaged bone and then position the new components to restore function to your shoulder.

Most patients are able to eat solid food and get out of bed the day after surgery. You will most likely be able to go home on the second or third day after surgery.

Tendon transfer is a surgical procedure by which a tendon and it's muscle (muscle-tendon unit) is moved from one location to another. The muscle-tendon unit is transferred in order to substitute the lost function (movement and stability) when repairs of failed muscle is impossible.

Tendon transfer surgery is a more extensive undertaking than direct rotator cuff repairs. It is often a 'salvage procedure' when direct repairs have failed or are impossible to perform due to the size of the tear or poor muscle and tendon quality. They are generally done by more specialised surgeons with an interest, training and experience in tendon transfer surgery.

Tendon transfer surgery will require a period of 1-2 months to heal completely. During this time, a splint or cast will be given following which you will be taught about the new tendon function. After the tendon transfer has healed, your surgeon may recommend exercises to strengthen the muscle. It is important to take care that you do not start movements too early as it may cause rupture of the tendon transfer and at the same time do not delay the movements. Delayed movement can lead to scarring of the tendon and stiffness.

Acromio Clavicular (AC) reconstruction is surgery to repair a ligament injury. A ligament is connective tissue that connects bones or holds a joint together. The AC is where the highest point of your shoulder bone meets your clavicle (collarbone).

This surgery may be done as an open surgery or arthroscopically. During an open procedure, one large and several small incisions are made. During an arthroscopic procedure, several small incisions are made. An arthroscope is used to look inside your joint.

After surgery, Your arm will be put into a sling for several weeks to keep it from moving while you heal. You will need to sleep in the sling and wear it during the day. You will be able to move your arm at the elbow and move your wrist and fingers. You may have a stiff or painful shoulder after surgery. This is normal and should get better with time and physical therapy. Your providers will tell you when to start having shoulder rehabilitation. These are exercises that will help increase your range of motion.

A surgery procedure to release a stiff elbow is typically performed if the patient is unable to straighten out their arm more than halfway or is unable to put their hand to their mouth.

Stiffness of the elbow can be the result of stiffness within the joint, outside the joint or because of the joint.

Elbow stiffness often occurs as a result a trauma or injury to the elbow and occasionally elbow arthritis. Common causes of pain in the elbow include sprains from overstretching a ligament, tennis elbow or golfer’s elbow (a condition caused by overuse called epicondylitis), a build-up of fluid over the elbow joint (bursitis) or repetitive strain injury. Note that heart conditions such as angina can also cause pain in the arm.

A doctor may also recommend you visit a physiotherapist, who could suggest movement exercises or a forearm strap designed to relieve pressure on the tendons in your elbow.

In severe cases, a doctor could recommend you for surgery. The release of stiff elbow surgery is often an arthroscopic (keyhole) procedure to remove spurs on the ends of bones and/or remove any loose bodies within the elbow.

Arthroscopic Debridement is a procedure that lets doctors see inside your wrist and hand joints through small incisions. The doctor uses a camera to navigate through the joint. They remove debris and irritants in the joints to reduce pain and inflammation. Arthroscopic debridement is common for knees and shoulders. The wrist is the third most common joint to have this procedure.

With arthroscopy, the doctor only has to make a small incision over the joint. That means the recovery time is shorter than with an open surgery. Arthroscopic debridement doesn't affect your soft tissues as much. You may have less pain, swelling and stiffness in your hands and wrists as you recover.

The aim of loose body removal surgery is to remove the cartilage or bone that has broken free during injuries and has caused the joints to be less mobile. Most loose body removal procedures are done using one of the following techniques:

Arthroscopy— This has become the surgery of choice for many doctors. It requires only a very small incision, and so is minimally invasive, leading to fewer complications. A camera is placed through the incision to allow the doctor to see the area where he or she will work. The loose body is then removed through a suction cup that is placed inside the body through another small incision.

Arthrotomy— For large loose bodies that cannot be removed via arthroscopy, a more extensive surgery may be needed. Instances of this are rare. This procedure uses a larger incision to get a better image inside the joint and allows the doctor to remove the loose body more easily.

A bone spur (osteophyte) is a bony growth formed on normal bone. It’s usually smooth, but it can cause wear and tear or pain if it presses or rubs on other bones or soft tissues such as ligaments, tendons, or nerves in the body. Surgery may be an option to remove or excise the bone spur.The surgery will take about 1 to 2 hours.

*Scapula (Shoulder Blade)

Treatment of Scapula Fractures:

Pain after an injury or surgery is a natural part of the healing process. Your doctor will work to reduce your pain, which can help you recover faster.

*Clavicle (collarbone)

A broken collarbone is a common injury, particularly in children and young adults. Your collarbone connects the upper part of your breastbone to your shoulder blade. Common causes of a broken collarbone include falls, sports injuries and trauma from traffic accidents. Infants can sometimes break their collarbones during the birth process. Surgery might be required if the fractured collarbone has broken through your skin, is severely displaced or is in several pieces. Broken collarbone surgery usually includes placing fixation devices — plates, screws or rods — to maintain proper position of your bone during healing. Surgical complications, though rare, can include infection and lack of bone healing.

*Shoulder and Elbow Surgery

Shoulder Arthroscopy:

Shoulder arthroscopy is a type of keyhole surgery that is used to look inside and treat damage to your shoulder caused by an injury, arthritis or certain health conditions. Shoulder arthroscopy is performed by making small cuts and placing a camera inside your shoulder, more than one cut is frequently required.

This surgery is commonly performed to repair the rotator cuff (which are muscle around the shoulder which help to move the shoulder and stabilise it), Treat shoulder impingement (which a major cause of shoulder pain) and stabilise the shoulder (some patients with recurrent dislocation can have their stability restored with surgery).

Elbow surgery:

The elbow is a hinge joint that also allows rotation of the forearm. Problems with the elbow may present as pain, swelling, stiffness or a tingling sensation. Tennis elbow is inflammation of the tendons on the outer side at the elbow joint. In the majority of cases, these problems can be treated with a combination of elbow braces, physiotherapy and appropriate injection techniques. Very rarely is surgery required.

Carpal instability occurs when the small bones in the wrist move out of position and compromise joint functioning. This may result when the ligaments that hold the bones together are torn or when the bones are fractured or affected by arthritis. Carpal instability causes ongoing pain and the loss of wrist functioning. Symptoms may improve with nonsurgical and surgical methods. Arthroscopic surgery is commonly used to treat carpal instability. An arthroscope is a very small surgical instrument. It contains a lens and lighting system that allows a surgeon to view inside a joint. The surgeon only needs to make small incisions and the joint does not have to be opened up fully. A miniature camera attached to an arthroscope allows a surgeon to view and record the magnified images on a video screen. Thin surgical instruments are inserted for surgery. An arthroscope may be used to reconstruct, trim, and repair torn ligaments.

Surgery to repair carpal instability is usually followed by a period of immobilization with splinting or casting, followed by hand therapy rehabilitation.

The triangular fibrocartilage complex (TFCC) is a cartilage structure located on the small finger side of the wrist that, cushions and supports the small carpal bones in the wrist. The TFCC keeps the forearm bones (radius and ulna) stable when the hand grasps or the forearm rotates. An injury or tear to the TFCC can cause chronic wrist pain.

Anyone can get a TCFF tear. It occurs most often in those who fall on an outstretched hand. Athletes are at risk, especially those who use a racquet, bat or club and those who put a lot of pressure on the wrist such as gymnasts. Degenerative tears are more common in people over 50. Medical attention should be sought as soon as possible after an injury to the wrist.

Surgery is generally needed for those tears that don't heal or respond to the conservative treatment. This can be performed arthroscopically through limited incisions. Some tears can be "fixed," simply by "debriding" or cleaning the torn edges and damaged tissue off. Others tears can be directly repaired using sutures. Recovery is several weeks in a cast or splint and usually requires therapy to get the wrist back to full function.

Arthroscopic debridement is a keyhole procedure that lets doctors see inside your wrist and hand joints through small incisions. The doctor uses a camera to navigate through the joint. They remove debris and irritants in the joints to reduce pain and inflammation. Arthroscopic debridement is common for knees and shoulders. The wrist is the third most common joint to have this procedure.

The procedure is minimally invasive with small incision over the joint and with faster recovery time. Arthroscopic debridement doesn't affect your soft tissues as much. You may have less pain, swelling and stiffness in your hands and wrists as you recover. Mostly patients go home the same day after the surgery.

After the surgery, you wear a bandage on your hand or wrist. This protects the incisions and keeps your wrist stable in the early days of recovery. Elevating your wrist prevents swelling, as does moving your fingers.

Ligament Reconstruction of Shoulder, Elbow, Wrist and Fingers

Nerve decompression surgery is a minimally invasive surgical procedure to relieve pressure caused by a neuroma – a pinched or entrapped nerve.

Patients suffering from peripheral neuropathy symptoms (numbness, pain, and/or functional loss) due to compressed nerves, who have not found relief through other, more conservative methods, may consider nerve decompression surgery. It is sometimes considered an alternative to a neuroma excision (completely removing the neuroma).

Surgeon makes a small incision with specialized surgical instruments are inserted into the incision. Instead of completely removing the swollen nerve, surgeon will relieve the pressure (decompress) by cutting tight tunnels around the nerve. This way, even though the nerve is still swollen, there is no pressure on it from surrounding structures in your body, enabling the nerve to start functioning normally again.

Facilities

24 hour casuality support
Digital imaging system
High definition Dynamic Ultrasound scanning system
3D Imaging CT scanner for Reconstruction
High definition MR scan to pick up small joint injuries
Contrast Imaging
High performing Laminar flow operating theatres
Fully equipped Intensive care and High dependency Unit
24 hour Intensivist's support for sick patients
Fully equipped Arthroscopic theatre with
Imported Shoulder arthroscopic Instruments
Special Athroscopic system for Elbow and wrist
Radiofrequency ablators
Imported Arthroscopic anchors and biodegradable implants
Short hospital stay for major surgery
Nerve Conduction studies in out patient clinic
Full facilities for diagnosis and management of Osteoporosis
Specialised physio and Upperlimb rehabilitation Unit
Scapulo-thoracic synchronisation programmes

Contact us

Sunrise Hospital, Cochin (www.sunrisehospitalcochin.com)

A Unit of Sunrise Institute of Medical Sciences Pvt Ltd, Kerala, India.

GST No 32AAICS4341K2ZB

Shoulder and Upper Limb Surgery

Shoulder and Upper Limb Surgery

Shoulder and Upper Limb Surgery

Doctors

Dr. Prathap Kumar KR

Treatment and Facilities

Surgical Treatments

Other procedures

Facilities

Support Services

Links

Sunrise Videos

Contact us

Sunrise Links

Sunrise Videos

Support Services

Other

Shoulder and Upper Limb Surgery

Shoulder and Upper Limb Surgery

Shoulder and Upper Limb Surgery

Doctors

Dr. Prathap Kumar KR

Treatment and Facilities

Specialist Upperlimb Unit - Shoulder & Elbow

Specialist Upperlimb Unit - Wrist & Hand

Arthroscopy (Keyhole Surgery) to fix most problems of Shoulder, Elbow and Wrist

Joint Replacement for Shoulder, Elbow and Small Joints of Hand Shoulder Joint Replacement

Small Joints of Hand Replacement

Surgery for Rheumatoid arthritis of Upper Limb

Correction of congenital and acquired deformities of Upper Limb

Management of complex fractures of Scapula (Shoulder blade), Shoulder, Elbow and Hand

Surgical Treatments

Shoulder Arthroscopy (Keyhole surgery) for - Anterior stabilization(Bankarts repair)

Superior Labrum Anterior and Posterior (SLAP) Repair

Tenodesis

Capsular release

Rotator cuff repair

Subacromial Decompression

Acromioclavicular (AC) Joint resection

Other procedures

Shoulder Resurfacing

Shoulder Replacement

Reverse Total Shoulder Replacement

Tendon transfers around shoulder

Acromio Clavicular Joint Reconstruction

Arthroscopic Release of the Stiff Elbow

Arthroscopic Debridement of joint

Removal of loose bodies

Excision of bony spur

Scapula, Clavicle, Shoulder and Elbow

Wrist arthroscopy (Keyhole) for - Carpal Instability

Triangular Fibrocartilage Complex (TFCC) Tear

Debridement for arthritis of the hand or wrist

Deformity correction

Decompression for Nerve entrapment

Facilities

Facilities

Support Services

Links

Sunrise Videos

Contact us