A New Method of Immobilization after Anterior Dislocation of the Shoulder

Abstract

An initial anterior dislocation of the shoulder became recurrent in 50% to 64% in patients younger than thirty years of age alter immobilization of the shoulder in internal rotation Magnatic resonance imaging and studies of cadavera have shown that coaptation of the Ban kart lesion is better with the arm in neutral rotation than it is with the arm in internal rotation. Our aim was to determine the benefit of immobilization in neutral rotation in a randomized controlled trial

Method: 25 patients with an initial anterior dislocation of the shoulder were randomly assigned to be treated with immobilization in either neutral rotate (12) or internal rotation (13) for three weeks The primary outcome measures was a recurrent dislocation or subluxation, the foIlow-up period was one year. Immobilizer in neutral rotation was designed and developed for this study at Samutsakhon Hospital.

Results : The follow up rate was 9 of 12 in neutral rotation group and 10 of 13 in IR group. The compliance rate was 8 of 9 in neutral rotation group and 9 of 10 in IR group The recurrent rate was 1 of 8 in neutral rotation group and 4 of 9 in IR group

conclusion : immobilization in neutral rotation after an initial shoulder dislocation reduces the risk of recurrence (12.5%) compared with that associated with the conventional method of immobilization in internal rotation (44.4%) in patients 30 year of age.