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. 2007 Jun;31(3):385-9.
doi: 10.1007/s00264-006-0183-y. Epub 2006 Aug 15.

Has the management of shoulder dislocation changed over time?

Byron Chalidis  1 , Nick Sachinis, Christos Dimitriou, Pericles Papadopoulos, Efthimios Samoladas, John Pournaras
Affiliations

Has the management of shoulder dislocation changed over time?

Byron Chalidis et al. Int Orthop. 2007 Jun.

Abstract
in English, French

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.

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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Figures

Fig. 1
Fig. 1
Treatment protocol
Fig. 2
Fig. 2
First dislocation age in patients with recurrent anterior shoulder dislocation (P≤0.001)
Fig. 3
Fig. 3
Rate of recurrence in relation to age (P≤0.001)
See this image and copyright information in PMC

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