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Multicenter Study
. 2015 Apr;135(4):447-54.
doi: 10.1007/s00402-015-2156-3. Epub 2015 Feb 21.

Survey on the management of acute first-time anterior shoulder dislocation amongst Dutch public hospitals

T D Berendes  1 , P Pilot, J Nagels, A J H Vochteloo, R G H H Nelissen
Affiliations
Multicenter Study

Survey on the management of acute first-time anterior shoulder dislocation amongst Dutch public hospitals

T D Berendes et al. Arch Orthop Trauma Surg. 2015 Apr.

Abstract

Introduction: The primary aim of this study was to record how orthopaedic surgeons are currently managing acute first-time anterior shoulder dislocation (AFASD) 8 years after introduction of the Dutch national guideline: "acute primary shoulder dislocation, diagnostics and treatment" in 2005. The second aim was to evaluate how these surgeons treat recurrent instability after AFASD.

Materials and methods: An online questionnaire regarding the management of AFASD and recurrent shoulder instability was held amongst orthopaedic surgeons of all 98 Dutch hospitals.

Results: The overall response rate was 60%. Of the respondents, 75% had a local protocol for managing AFASD, of which 28% had made changes in their treatment protocol after the introduction of the national guideline. The current survey showed wide variety in the overall treatment policies for AFASD. Twenty-seven percent of the orthopaedic surgeons were currently unaware of the national guideline. The variability in treatment for AFASD was present throughout the whole treatment from which policy at the emergency department; when to operate for recurrent instability; type of surgical technique for stabilization and type of fixation of the labrum. As for the treatment of recurrent instability, the same variability was seen: 36% of the surgeons perform only arthroscopic procedures, 7% only open and 57% perform both open and arthroscopic procedures.

Conclusions: Despite the introduction of the national guideline for the initial management of AFASD in 2005, still great variety among orthopaedic surgeons in the Netherlands was present. As for the surgical stabilization technique, the vast majority of the respondents are performing an arthroscopic shoulder stabilization procedure at the expense of the more traditional open procedure as a first treatment option for post-traumatic shoulder instability.

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Figures

Fig. 1
Fig. 1
Flowchart treatment of acute primary anterior shoulder dislocation according to Dutch national guideline 2005
See this image and copyright information in PMC

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