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Immobilization of the shoulder in external rotation for prevention of recurrence in acute anterior dislocation
Taskoparan H, Kilincoglu V, Tunay S, Bilgic S, Yurttas Y, Komurcu M
Acta Orthopaedica et Traumatologica Turcica 2010;44(4):278-284
clinical trial
3/10 [Eligibility criteria: No; Random allocation: No; Concealed allocation: No; Baseline comparability: No; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVES: We aimed to compare the functional and stability outcomes of the patients with acute anterior shoulder dislocation, who were stabilized at external versus internal rotation. METHODS: A total of 33 patients (31 males and 2 females) with the diagnosis of acute primary traumatic anterior shoulder dislocation were immobilized at internal (n = 17) or external rotation (n = 16). The mean follow-up period was 20.85 months (range 6 to 41 months). Patients received rehabilitation program immediately after splinting. We assessed functionality by Constant-Murlay score and stability by Rowe scoring system in 6th month. Control examinations were performed in 12th and 24th months. RESULTS: There were no statistically significant differences between internal rotation and external rotation groups in terms of Constant-Murlay and Rowe scores. Recurrent dislocation rate was 6.3% (1/16) in external rotation group and 29.4% (5/17) in internal rotation group (p > 0.05). In the subgroup of patients aged between 21 to 30 years, while no recurrent dislocation was seen in external rotation group, 5 patients developed recurrent dislocation in internal rotation group(p = 0.035). CONCLUSION: Immobilization of the shoulder in external rotation is an effective technique for prevention of recurrent dislocations in acute anterior shoulder dislocation and should be preferred to traditional splinting in internal rotation in clinical practice.

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