Evaluation of immobilization in external rotation after primary traumatic anterior shoulder dislocation: 5-year results

被引：8
作者：
Königshausen M. [1 ]
Schliemann B. [2 ]
Schildhauer T.A. [1 ]
Seybold D. [1 ]
机构：
[1] Department of General and Trauma Surgery, BG Universitätsklinikum Bergmannsheil, Ruhr-Universität Bochum, 44789 Bochum
[2] Department of Trauma-, Hand- and Reconstructive Surgery, Universitätsklinikum Münster, 48148 Münster
来源：
MUSCULOSKELETAL SURGERY | 2014年 / 98卷 / 2期
关键词：
Bankart lesion; External rotation; Immobilization; Non-operative treatment; Shoulder dislocation;
D O I：
10.1007/s12306-013-0276-x
中图分类号：
学科分类号：
摘要：
Background: It is still not clear which method is the most efficient for treating primary traumatic anterior shoulder dislocation. Immobilization in external rotation has become increasingly discussed within the last 10 years. The aim of this study was to evaluate the rate of recurrence and clinical outcome of the immobilization in external rotation after primary traumatic anterior dislocation within a midterm period of 5 years. Additionally, a summary of literature is given according to the present knowledge of this issue. Methods: From May 2004 to May 2006, 28 patients with primary traumatic anterior shoulder dislocations were included in a prospective MRI-controlled study. After a follow-up of 5 years, the recurrence rate and clinical outcomes of the patients were evaluated using clinical scores (Constant and Murley score, Western Ontario Shoulder Instability Index, Rowe score). Results: After 5 years, 26 patients (93 %; males, n = 25; female, n = 1; mean age, 29.3 years) were interviewed concerning re-dislocations. In the meantime, four patients (15 %) experienced a re-dislocation (ø 12.2 months) after the end of the immobilization. Overall, 21 patients (75 %) were included in a clinical follow-up (CM score: ø 92.8 points; Western Ontario Shoulder Instability Index: ø 87 %; Rowe score (in 17 patients): ø 94.2 points). Upon clinical examination, unidirectional anterior instability was found in one patient, which corresponds to an overall instability rate of 19 % within the examined patient population including the re-dislocations. Conclusions: Immobilization in external rotation shows satisfactory results after 5 years in regard to recurrence and instability rates and clinical outcomes. The data show that with immobilization in external rotation, re-dislocations occur within the first 2 years. © 2013 Istituto Ortopedico Rizzoli.
引用
收藏
页码：143 / 151
页数：8
相关论文
共 31 条
  • [11] Kirkley A., Griffin S., McLintock H., Ng L., The development and evaluation of a disease-specific quality of life measurement tool for shoulder instability. The Western Ontario Shoulder Instability Index (WOSI), Am J Sports Med, 26, pp. 764-772, (1998)
  • [12] Boehm D., Wollmerstedt N., Doesch M., Handwerker M., Mehling E., Gohlke F., Development of a questionnaire based on the Constant-Murley-Score for self-evaluation of shoulder function by patients, Unfallchirurg, 107, pp. 397-402, (2004)
  • [13] Lill H., Verheyden P., Korner J., Hepp P., Josten C., Conservative treatment after first traumatic shoulder dislocation, Chirurg, 69, pp. 1230-1237, (1998)
  • [14] Hovelius L., Augustini B.G., Fredin H., Johansson O., Norlin R., Thorling J., Primary anterior dislocation of the shoulder in young patients. A ten-year prospective study, J Bone Joint Surg Am, 78, pp. 1677-1684, (1996)
  • [15] Miller B.S., Sonnabend D.H., Hatrick C., O'Leary S., Goldberg J., Harper W., Walsh W.R., Should acute anterior dislocations of the shoulder be immobilized in external rotation? A cadaveric study, J Shoulder Elbow Surg, 13, pp. 589-592, (2004)
  • [16] Seybold D., Gekle C., Fehmer T., Pennekamp W., Muhr G., Kalicke T., Immobilization in external rotation after primary shoulder dislocation, Chirurg, 77, pp. 821-826, (2006)
  • [17] Hart W.J., Kelly C.P., Arthroscopic observation of capsulolabral reduction after shoulder dislocation, J Shoulder Elbow Surg, 14, pp. 134-137, (2005)
  • [18] Schliemann B., Seybold D., Muhr G., Gekle C., Immobilisation of the shoulder in external rotation after traumatic first-time dislocation-what is reasonable? A retrospective survey, Sportverletz Sportschaden, 23, pp. 100-105, (2009)
  • [19] Robinson C.M., Kelly M., Wakefield A.E., Redislocation of the shoulder during the first six weeks after a primary anterior dislocation: Risk factors and results of treatment, J Bone Joint Surg Am, 84 A, pp. 1552-1559, (2002)
  • [20] Rowe C.R., Sakellarides H.T., Factors related to recurrences of anterior dislocations of the shoulder, Clin Orthop, 20, pp. 40-48, (1961)
1234