Immobilization in internal or external rotation does not change recurrence rates after traumatic anterior shoulder dislocation

Vavken, Patrick; Sadoghi, Patrick; Quidde, Julia; Lucas, Robert M.; Delaney, Ruth A.; Müeller, Andreas; Rosso, Claudio; Valderrábano, Víctor

doi:10.1016/j.jse.2013.07.037

Cited by 33 publications

(26 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Four meta-analyses comparing the effects of immobilization in ER and IR in large groups of patients in level I–IV studies were identified [48–51]. Out of these, 2 demonstrated no significant difference between the 2 methods of immobilization (Liu and Vavken), 1 found the results of immobilization in ER were significantly better (Longo), and 1 showed a tendency towards better results in patients immobilized in ER (but without statistical significance) (Paterson).…”

Section: Meta-analysesmentioning

confidence: 99%

“…Out of these, 2 demonstrated no significant difference between the 2 methods of immobilization (Liu and Vavken), 1 found the results of immobilization in ER were significantly better (Longo), and 1 showed a tendency towards better results in patients immobilized in ER (but without statistical significance) (Paterson). Vavken et al found the p values to be borderline and highlighted the influence of patient age [51]. The meta-analysis with the largest number of patients (663) included in 7 studies, demonstrated no superiority of immobilization in ER regardless of age, and in 2 groups stratified by age (≤30; >30 years) [48].…”

Section: Meta-analysesmentioning

confidence: 99%

See 1 more Smart Citation

Position of Immobilization After First-Time Traumatic Anterior Glenohumeral Dislocation: A Literature Review

2017

View full text Add to dashboard Cite

Anterior glenohumeral dislocation affects about 2% of the general population during the lifetime. The incidence of traumatic glenohumeral dislocation ranges from 8.2 to 26.69 per 100 000 population per year. The most common complication is recurrent dislocation occurring in 17–96% of the patients. The majority of patients are treated conservatively by closed reduction and immobilization in internal rotation for 2–3 weeks. However, no clear conservative treatment protocol exists. Immobilization in external rotation can be considered an alternative. A range of external rotation braces are commercially available.The purpose of this work was to review the current literature on conservative management of glenohumeral dislocation and to compare the results of immobilization in internal and external rotation.A comprehensive literature search and review was performed using the keywords “glenohumeral dislocation”, “shoulder dislocation”, “immobilization”, “external rotation”, and “recurrent dislocation” in PubMed, MEDLINE, Cochrane Library, Scopus, and Google Scholar databases from their inceptions to May 2016.Three cadaveric studies, 6 imaging studies, 10 clinical studies, and 4 meta-analyses were identified. The total number of 734 patients were included in the clinical studies.Literature analysis revealed better coaptation of the labrum on the glenoid rim in external rotation in cadaveric and imaging studies. However, this tendency was not confirmed by lower redislocation rates or better quality of life in clinical studies.On the basis of the available literature, we cannot confirm the superiority of immobilization in external rotation after glenohumeral dislocation when compared to internal rotation. A yet-to-be-determined group of patients with specific labroligamentous injury pattern may benefit from immobilization in external rotation. Further studies are needed to identify these patients.

show abstract

Section: Meta-analysesmentioning

confidence: 99%

Section: Meta-analysesmentioning

confidence: 99%

Position of Immobilization After First-Time Traumatic Anterior Glenohumeral Dislocation: A Literature Review

2017

View full text Add to dashboard Cite

show abstract

“…External rotation does not create any advantage as recently shown [ 40 ]. Afterwards, a range of motion (ROM) exercises are begun and, depending on patient's progress, strengthening exercises are initiated at week 8.…”

Section: Rehabilitationmentioning

confidence: 99%

“…A recent meta-analysis has shown no benefi t of the arm in external rotation [ 40 ]. In the majority of the cases, in the presence of a bony fragment, operative treatment is the treatment of choice after a traumatic anterior shoulder dislocation.…”

Section: Nonoperative Treatmentmentioning

confidence: 99%

Traumatic Anterior Shoulder Instability: Part II. Bony Bankart – Small Versus Large Lesions

Lafosse¹,

Fogerty

Rosso

2015

Sports Injuries to the Shoulder and Elbow

Self Cite

View full text Add to dashboard Cite

“…Randomised controlled trials by Liavaag et al (2011) and Whelan et al (2014) have demonstrated no reduction in reoccurrence rates by managing the patient in an external rotation brace vs. the more traditional approach of internal rotation. In support of this view a recent systematic review by Vavken et al (2014) concludes that current evidence does not support the effectiveness of immobilisation in external rotation compared with internal rotation. The patient was therefore managed in the more conventional internal rotation position using a simple shoulder immobiliser (Polysling™).…”

Section: Post-reduction Case Progressionmentioning

confidence: 99%

Shoulder instability: A myriad of decisions for optimal emergency department care

Duignan

2015

International Emergency Nursing

View full text Add to dashboard Cite

Immobilization in internal or external rotation does not change recurrence rates after traumatic anterior shoulder dislocation

Cited by 33 publications

References 31 publications

Position of Immobilization After First-Time Traumatic Anterior Glenohumeral Dislocation: A Literature Review

Position of Immobilization After First-Time Traumatic Anterior Glenohumeral Dislocation: A Literature Review

Traumatic Anterior Shoulder Instability: Part II. Bony Bankart – Small Versus Large Lesions

Shoulder instability: A myriad of decisions for optimal emergency department care

Contact Info

Product

Resources

About