Indexing
All Issues
Submission
Author Guidelines
Reviewers
Editorial Members
Publication Fee
Vol.2 , No. 4, Publication Date: Aug. 3, 2015, Page: 49-53
 Lady Reading Hospital (LRH) Peshawar, Khyber Pakhtunkhwa, Pakistan from May 2011 to May 2015.A total of eighteen patients(14 male and 4 females) mean age 32 years with first episode traumatic anterior shoulder dislocation fulfilling the inclusion criteria were treated with close reduction under general anaesthesia and sling immobilization followed by supervised physical therapy program. Patients received regular clinical follow-up for a minimum of two years to assess whether recurrent dislocation had developed or not. Eight (47%) patients has had recurrent shoulder dislocation with majority (75%,n=6) under 30 years of age. Patients younger than 22 years at the time of first dislocation showed a shorter interval of redislocation(12-16 weeks) and a higher frequency of dislocations(3-5).Patients with Bankart lesions had a higher frequency of recurrent dislocations (62.5%,n=5) In conclusion non operative treatment of traumatic anterior shoulder dislocation with close reduction and sling immobilization leads to a high rate of recurrent dislocation. Patients under the age of thirty years were more likely to have recurrent shoulder dislocation than over thirty years old.&picture=http://www.aascit.org/aascit/decorators/img/journal/906.jpg)
| [1] | Faaiz Ali Shah, Senior Registrar Orthopaedics & Traumatology Unit “A”, Medical Teaching Institution (MTI), Lady Reading Hospital (LRH) Peshawar, Khyber Pakhtunkhwa, Pakistan. |
| [2] | Waqar Alam, District Headquarter Hospital Temargarh Lower Dir., Khyber Pakhtunkhwa, Pakistan. |
| [3] | Shahab ud Din, Department Orthopaedics & Traumatology, Medical Teaching Institution (MTI), Lady Reading Hospital (LRH) Peshawar, Khyber Pakhtunkhwa, Pakistan. |
Traumatic anterior shoulder dislocation has high rate of recurrence when treated non operatively especially in young active patients. An evidence-based approach is therefore necessary to determine the best treatment regime for a patient presenting initially with traumatic anterior shoulder dislocation. The purpose of this study was to determine the frequency of recurrent shoulder dislocation after primary traumatic anterior dislocation treated non operatively. The study design was prospective observational cohort and was conducted in level I Orthopaedic and Traumatology Unit “A” Medical Teaching Institution (MTI) Lady Reading Hospital (LRH) Peshawar, Khyber Pakhtunkhwa, Pakistan from May 2011 to May 2015.A total of eighteen patients(14 male and 4 females) mean age 32 years with first episode traumatic anterior shoulder dislocation fulfilling the inclusion criteria were treated with close reduction under general anaesthesia and sling immobilization followed by supervised physical therapy program. Patients received regular clinical follow-up for a minimum of two years to assess whether recurrent dislocation had developed or not. Eight (47%) patients has had recurrent shoulder dislocation with majority (75%,n=6) under 30 years of age. Patients younger than 22 years at the time of first dislocation showed a shorter interval of redislocation(12-16 weeks) and a higher frequency of dislocations(3-5).Patients with Bankart lesions had a higher frequency of recurrent dislocations (62.5%,n=5) In conclusion non operative treatment of traumatic anterior shoulder dislocation with close reduction and sling immobilization leads to a high rate of recurrent dislocation. Patients under the age of thirty years were more likely to have recurrent shoulder dislocation than over thirty years old.
Keywords
Shoulder Dislocation, Recurrent, Traumatic
Reference
| [01] | Zacchilli MA, Owens BD. Epidemiology of shoulder dislocation presenting to emergency departments in the United States. J Bone Joint Surg Am.2010;92(3):542-549. |
| [02] | Hayes K, Callanan M, Walton J, Paxinos A, Murrell GA. Shoulder instability: Management and rehabilitation. J Orthop Sports PhysTher.2002;32(10):497-509. |
| [03] | TeSlaa RL, Wijffels JM, Marti RK. Questionnaire reveals variations in the management of acute first time shoulder dislocations in the Netherlands. Eur J Emerg Med. 2003; 10:58-61. |
| [04] | Chong M, Karataglis D, Learmonth D. Survey of the management of acute traumatic first-time anterior shoulder dislocation among trauma clinicians in the UK. Ann R Coll Surg Eng 2006; 88:454-8. |
| [05] | Davy A, Drew S. Management of shoulder dislocation: Are we doing enough to reduce the risk of recurrence? Injury Int J Care Injured.2002 ;33:775-779. |
| [06] | Sachs RA, Lin D, Stone ML, Paxton E, Kuney M. Can the need for future surgery for acute traumatic anterior shoulder dislocation be predicted? J Bone Joint Surg Am. 2007;89(8):1665-1674. |
| [07] | Murrell GA . Treatment of shoulder dislocation:Is a sling appropriate? Med J Australia 2003; 179:370-371. |
| [08] | Smith T. Immobilisation following traumatic anterior glenohumeral joint dislocation: A literature review. Injury Int J Care injured.2006:228-237. |
| [09] | McRae R, Esser M. Practical fracture treatment. 4th edn. London: Churchill Livingstone, 2004. |
| [10] | Brophy RH, Marx RG. The treatment of traumatic anterior instability of the shoulder: Nonoperative and surgical treatment.Arthroscopy.2009;25(3):298-304. |
| [11] | Rowe CR. Prognosis in dislocations of the shoulder. J Bone Joint Surg Am.1956; 38:957-77. |
| [12] | Robinson CM, Howes J, Murdoch H, Will E ,Graham C. Functional outcome and risk of recurrent instability after primary traumatic anterior shoulder dislocation in young patients. J Bone Joint Surg Am 2006; 88:2326-36. |
| [13] | Postacchini F, Gumina S, Cinotti G. Anterior shoulder dislocation in adolescents. J Shoulder Elbow Surg 2000;9:470-4. |
| [14] | Rapariz JM, Martin SM, Bezares AP, Klein JO. Shoulder dislocation in patients older than 60 years of age.Int J Shoulder Surg. 2010;4(4): 88-92. |
| [15] | Hovelius L, Olofsson A, Sandstrom B, Augustini BG, Krantz L,Fredin H et al. Nonoperative treatment of primary anterior shoulder dislocation in patients forty years of age and younger: A prospective twenty-five-year follow-up. J Bone Joint Surg Am. 2008;5:945-952. |
| [16] | Chalidis B, Sachinis N, Dimitriou C, Papadopoulos P, Samoladas E Pournaras J. Has the management of shoulder dislocation changed over time? Int Orthop. 2007; 31(3): 385-389. |
| [17] | Te-Sala RL, Wijffels JM, Brand R, Marti Rk. The prognosis following acute primary glen humeral dislocation. J Bone Joint Surg Br. 2004;86(1);58-64. |
| [18] | Kralinger FS, Golser K, Wischatta R, Wambacher M,Sperner G. Predicting recurrence after primary anterior shoulder dislocation. Am J Sports Med. 2002; 30(1): 116-120. |
| [19] | Jakobsen BW, Johannsen HV, Suder P, Sojbjerg JO. Primary repair versus conservative treatment of first-time traumatic anterior dislocation of the shoulder: A randomized study with 10-year follow-up .The Journal of Arthroscopic & Related Surgery.2007;23(2);118-123. |
| [20] | Itoi E, Hatakeyama Y, Kido T, Sato T, Minagawa H, Wakabayashi I, et al. A new method of immobilisation after traumatic anterior dislocation of the shoulder: A preliminary study. J Shoulder Elbow Surg. 2003;12:413-5. |
| [21] | Chong M, Karataglis D, Learmonth D. Survey of the management of acute traumatic first-time anterior shoulder dislocation among trauma clinicians in the UK. Ann R CollSurg Engl. 2006;88(5):454-458. |
| [22] | Vavken P, Sadoghi P, Quidde J, Lucas R, Delaney R, Muller AM et al. Immobilization in internal or external rotation does not change recurrence rates after traumatic anterior shoulder dislocation. J Shoulder Elbow Surg.2014 ;23(1):13-9. |
| [23] | Wheeler JH, Ryan JB, Arciero RA, Molinari RN. Arthroscopic versus nonoperative treatment of acute shoulder dislocations in young athletes. The Journal of Arthroscopic and Related Surgery.1989; 5( 3): 213-217. |
| [24] | Kirkley A, Werstine R, Ratjek A,Griffin S. Prospective randomized clinical trial comparing the effectiveness of immediate arthroscopic stabilization versus immobilization and rehabilitation in first traumatic anterior dislocations of the shoulder: Long-term evaluation. The journal of Arthroscopic & Related Surgery. 2005;21(1):55-63. |
| [25] | Wintzell G, Hovelius L, Wikblad L, Saebo M, Larsson S. Arthroscopic lavage speeds reduction in effusion in the glenohumeral joint after primary anterior shoulder dislocation: a controlled randomized ultrasound study. Knee Surg Sports Traumatol Arthrosc.2000; 8(1):56-60. |
