Article

Immobilization in external rotation (ER) for shoulder
dislocation has been reported to improve the coaptation of Bankart lesions to the
glenoid. We compared the position of the labrum in patients treated with
immobilization in ER or internal rotation (IR). A secondary aim was to evaluate
the rate of Bankart lesions. METHODS: 55 patients with primary
anterior shoulder dislocation, aged between 16 and 40 years, were randomized to
immobilization in ER or IR. Computer tomography (CT) and magnetic resonance
imaging (MRI) were performed shortly after the injury.
After the immobilization,
MRI arthrography was performed. We evaluated the rate of Bankart lesions and
measured the separation and displacement of the labrum as well as the length of
the detached part of the capsule on the glenoid neck. RESULTS: Immobilization in
ER reduced the number of Bankart lesions (OR = 3.8, 95% CI: 1.1 -13; p = 0.04).
Separation decreased to a larger extent in the ER group than in the IR group
(mean difference 0.6 mm, 95% CI: 0.1 - 1.1, p = 0.03). Displacement of the labrum
and the detached part of the capsule showed no significant differences between
the groups. INTERPRETATION: Immobilization in ER results in improved coaptation
of the labrum after primary traumatic shoulder dislocation.

Langue : ANGLAIS