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Has the management of shoulder dislocation changed over time?

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Abstract

Anterior shoulder dislocation is a disabling injury affecting all ages, young and old alike. Recently, the treatment of traumatic shoulder dislocation has included immobilisation for varying periods of time followed by physiotherapy. This study is the first in this country to address the demographic data and recurrence rates of shoulder dislocation. Three hundred and eight patients (170 men and 138 women) were followed up for an average of 5.9 years. The most frequent mechanism of injury was a fall (65.66% of cases), and in 92.1% of the patients, the shoulder was reduced in the Emergency Department without the need for sedation or general anaesthesia. The overall recurrence rate in all ages was 50%, but rose to 88.9% in the 14–20-year age group. The duration of immobilisation did not affect the rate of re-dislocation of the humeral head. We believe that conventional shoulder immobilisation in a sling offers no benefits, and it would be preferable not to immobilise the shoulder at all.

Résumé

Les luxations antérieures de l’épaule sont une affection qui peut survenir à n’importe quel âge, aussi bien chez les jeunes que chez les patients plus âgés. Jusqu’à ce jour, le traitement des luxations de l’épaule comprend une immobilisation suivi d’une période de rééducation. Cette étude est la première qui met en évidence des données démographiques et des résultats concernant la récidive de la luxation. Trois cent huit patients (170 hommes et 138 femmes) ont été suivis pendant une période de 5,9 ans. Le mécanisme le plus fréquent a été la chute (65,66%) et dans 92,1% des cas la luxation a été réduite aux services d’urgence, sans anesthésie générale et sans sédation particulière. Le taux de récidive quel que soit l’âge a été de 50% mais augmente à 88,9% dans le groupe des patients les plus jeunes (14 à 20 ans). Le temps d’immobilisation n’affecte pas le taux de reluxation. Nous pensons que l’immobilisation conventionnelle de l’épaule n’apporte aucun bénéfice et qu’il est préférable de ne pas immobiliser celle-ci à la suite d’une luxation.

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References

  1. Arciero RA, Wheeler JH, Ryan JB, McBride JT (1994) Arthroscopic Bankart repair versus nonoperative treatment for acute, initial anterior shoulder dislocations. Am J Sports Med 22(5):589–594

    PubMed  CAS  Google Scholar 

  2. Aronen JG, Regan K (1984) Decreasing the incidence of recurrence of first time anterior shoulder dislocations with rehabilitation. Am J Sports Med 12:283–291

    PubMed  CAS  Google Scholar 

  3. Burkhead WZ, Rockwood CA (1992) Treatment of instability of the shoulder with an exercise program. J Bone Jt Surg Ser A 74:890–896

    Google Scholar 

  4. Davy A, Drew S (2002) Management of shoulder dislocation-are we doing enough to reduce the risk of recurrence? Injury Int J Care Injured 33 775–779

    Google Scholar 

  5. Gleeson AP (1998) Anterior glenohumeral dislocation: what to do and how to do it. J Accid Emerg Med 15:7–12

    PubMed  CAS  Google Scholar 

  6. Hatrick C, O’Leary S, Miller B et al (2002) Should acute anterior dislocation of the shoulder be treated in external rotation. Transactions of the 48th Annual Meeting of the Orthopaedic Research Society. Dallas, Texas

  7. Henry JH, Genung JA (1982) The natural history of glenohumeral dislocation: revisited. Am J Sports Med 10:135–137

    PubMed  CAS  Google Scholar 

  8. Hovelius L, Lind B, Thorling J (1983) Primary dislocation of the shoulder: factors affecting the 2-year prognosis. Clin Orthop Relat Res 176 181–185

    PubMed  Google Scholar 

  9. Itoi E et al (2003) A new method of immobilisation after traumatic anterior dislocation of the shoulder: a preliminary study. J Shoulder Elbow Surg Sept/Oct, 413–415

  10. Itoi E et al (2001) Position of immobilisation after dislocation of the glenohumeral joint. A study with use of magnetic resonance imaging. J Bone Joint Surg Am 83-A(5):661–667

    PubMed  CAS  Google Scholar 

  11. Kazar B, Relovszky E (1969) Prognosis of primary dislocation of the shoulder. Acta Orhop Scand 40:216–224

    Article  CAS  Google Scholar 

  12. Kralinger FS, Golser K, Wischatta R et al (2002) Predicting recurrence after primary anterior shoulder dislocation. Am J Sports Med 30(1):116–120

    PubMed  Google Scholar 

  13. Larrain MV, Botto GJ, Montenegro HJ, Muaus DM (2001) Arthroscopic repair of acute traumatic anterior shoulder dislocation in young athletes. Arthroscopy 17:373–377

    Article  PubMed  CAS  Google Scholar 

  14. Yuen M-C et al (2001) An easy method to reduce anterior shoulder dislocation: the Spaso technique. Emerg Med J 18:370–372

    Article  PubMed  CAS  Google Scholar 

  15. Murrell GAC (2003) Treatment of shoulder dislocation: is a sling appropriate? Med J Australia 179:370–371

    PubMed  Google Scholar 

  16. Riebel GD, McCabe JB (1991) Anterior shoulder dislocation: a review of reduction techniques. Orthop Rev Jun 20(6):563–566

    Google Scholar 

  17. Robinson CM et al (2002) Redislocation of the shoulder during the first six weeks after a primary anterior dislocation: risk factors and results of treatment J. Bone Joint Surg Am 84:1552–1559

    Google Scholar 

  18. Rockwood CH (2004) ‘The shoulder’, 3rd edn. 2:655–794

  19. Rowe CR (1963) Anterior dislocation of the shoulder. Surg Clin North Am 43:1609

    PubMed  CAS  Google Scholar 

  20. Rowe CR (1956) Prognosis in dislocations of the shoulder. J Bone Jt Surg Ser A 38:957–977

    Google Scholar 

  21. Rowe CR, Sakellarides HT (1961) Factors related to recurrences of anterior dislocations of the shoulder. Clin Orthop 20:40–48

    PubMed  CAS  Google Scholar 

  22. Smith T (2006) Immobilisation following traumatic anterior glenohumeral joint dislocation. A literature review, Injury. Int J Care injured 228–237

  23. Taylor DC, Arciero RA (1997) Pathologic changes associated with shoulder dislocations. Am J Sports Med 25:306–311

    PubMed  CAS  Google Scholar 

  24. Wintzell G, Haglund-Åkerlind Y et al (1999) Arthroscopic lavage compared with non-operative treatment for traumatic primary anterior shoulder dislocation; a 2-year follow-up of a prospective randomized study. J Shoulder Elbow Surg 8:399–402

    Article  PubMed  CAS  Google Scholar 

  25. Yoneda B, Welsh RP, Macintosh DL (1982) Conservative treatment of shoulder dislocations in young males. J Bone Jt Surg Ser B 64:254–255

    Google Scholar 

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Authors and Affiliations

  1. First Orthopaedic Department, Aristotle University of Thessaloniki, “G.Papanikolaou” Hospital, Exohi, 57010, Thessaloniki, Greece

    Byron Chalidis, Nick Sachinis, Christos Dimitriou, Pericles Papadopoulos, Efthimios Samoladas & John Pournaras

  2. 33, Agias Triadas Str., Pefka, 57010, Thessaloniki, Greece

    Byron Chalidis

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  1. Byron Chalidis
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  2. Nick Sachinis
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  3. Christos Dimitriou
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  6. John Pournaras
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Correspondence to Byron Chalidis.

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Chalidis, B., Sachinis, N., Dimitriou, C. et al. Has the management of shoulder dislocation changed over time?. International Orthopaedics (SICOT) 31, 385–389 (2007). https://doi.org/10.1007/s00264-006-0183-y

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  • DOI: https://doi.org/10.1007/s00264-006-0183-y

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