Original articleA new method of immobilization after traumatic anterior dislocation of the shoulder: a preliminary study
Section snippets
Materials and methods
From January 2000, 42 patients with an initial anterior dislocation of the shoulder were referred to our institutions. Of these, 14 had undergone reduction and were referred to us, whereas the remaining 28 visited us directly with their shoulders dislocated. After routine radiographic examination of the anteroposterior view, the shoulders were reduced manually. Radiographic examination revealed a fracture of the greater tuberosity in 9 cases and a fracture of the glenoid in 1 case. The greater
Results
Five patients in the IR group (twenty-five percent) and four patients in the ER group (twenty percent) took off the immobilizer in less than a week despite our instructions. All others immobilized the shoulder for 3 weeks as instructed. There was no significant difference in compliance (P = .70). The recurrence rate was 6 of 20 in the IR group (30%) and 0 of 20 in the ER group (0%) (P = .008). Among those who were aged younger than 30 years, the recurrence rate was 5 of 11 in the IR group (45%)
Discussion
Immobilization in internal rotation after shoulder dislocation has been performed for over 2000 years, since the era of Hippocrates.4 Surprisingly, there has been no evidence that this position is optimum for healing of the Bankart lesion. The shoulder never redislocates in 52% of patients after an initial dislocation, and recurrent dislocations spontaneously cease in 20% of patients with recurrent dislocations.5 This information suggests that the Bankart lesion has the ability to heal.
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