Article

It is still not clear which method is the most efficient for treating
primary traumatic anterior shoulder dislocation. Immobilization in external
rotation has become increasingly discussed within the last 10 years. The aim of
this study was to evaluate the rate of recurrence and clinical outcome of the
immobilization in external rotation after primary traumatic anterior dislocation
within a midterm period of 5 years. Additionally, a summary of literature is
given according to the present knowledge of this issue.
METHODS: From May 2004 to
May 2006, 28 patients with primary traumatic anterior shoulder dislocations were
included in a prospective MRI-controlled study. After a follow-up of 5 years, the
recurrence rate and clinical outcomes of the patients were evaluated using
clinical scores (Constant and Murley score, Western Ontario Shoulder Instability
Index, Rowe score). RESULTS: After 5 years, 26 patients (93 %; males, n = 25;
female, n = 1; mean age, 29.3 years) were interviewed concerning re-dislocations.
In the meantime, four patients (15 %) experienced a re-dislocation (o 12.2
months) after the end of the immobilization. Overall, 21 patients (75 %) were
included in a clinical follow-up (CM score: o 92.8 points; Western Ontario
Shoulder Instability Index: o 87 %; Rowe score (in 17 patients) :
o 94.2 points).
Upon clinical examination, unidirectional anterior instability was found in one
patient, which corresponds to an overall instability rate of 19 % within the
examined patient population including the re-dislocations. CONCLUSIONS:
Immobilization in external rotation shows satisfactory results after 5 years in
regard to recurrence and instability rates and clinical outcomes.
The data show
that with immobilization in external rotation, re-dislocations occur within the first 2 years.

Langue : ANGLAIS