Immobilization in External Rotation of Acute Shoulder Dislocations

A Randomized Evaluation of Immobilization in External Rotation in the Management of Acute Anterior Dislocations of the Shoulder

The purpose of this study is to determine whether immobilizing the affected shoulder of first time anterior shoulder dislocation patients in external rotation (vs immobilization in traditional internal rotation) reduces the rate of recurrent dislocations experienced in 24 months.

Immobilizing the affected shoulder of first time anterior shoulder dislocation patients in external rotation (vs immobilization in traditional internal rotation)should reduce the rate of recurrent dislocations experienced in 24 months.

Inclusion Criteria:

• skeletally mature patients less than 30 years of age
• sustained an acute, first-time, traumatic anterior dislocation of the shoulder as defined by; i. Mechanism of abduction, external rotation ii. Sudden pain in the shoulder iii. Manipulative reduction required or iv. Radiograph documenting a dislocated joint
• willing to participate in follow-up for at least two years

Exclusion Criteria:

• incompetent or unwilling to consent
• inability or unwillingness to comply with rehabilitative protocol or required follow-up assessments
• previous instability of the affected shoulder
• significant associated fracture (exception Hill Sachs or Bankart lesions)
• concomitant ipsilateral upper extremity injuries which may affect the patient's ability to participate in, or benefit from, a rehabilitative program
• a history of significant ligamentous laxity or demonstrated multi-directional instability of the contralateral shoulder
• neurovascular compromise of the affected limb
• a medical condition making the patient unable to wear a brace or sling