Immobilization in External Rotation After Primary Shoulder Dislocation Did Not Reduce the Risk of Recurrence

Abstract

Immobilization in external rotation does not reduce the rate of recurrence for patients with first-time traumatic anterior shoulder dislocation.

Reply to the Letter to the Editor

“…Rhon and Hando for their interest and insightful comments regarding our recently published study. While we would wholeheartedly agree that a period of immobilization longer than the 3 or 4 weeks employed in our study and others [1][2][3] would be beneficial to soft tissue healing, the practicalities of doing so may limit its utility. According to our (as well as Professor Itoi's) observations, compliance with brace wear was a time-limited phenomenon.…”

BESS/BOA Patient Care Pathways

“…One randomized controlled trial has supported the use of external rotation braces applied on the day of dislocation at reducing the risk of recurrence from 42% to 26% (p ¼ 0.033) over 2 years 23 Two further randomized controlled trials, however, have failed to show a benefit of external rotation bracing 24,25 Summary: The evidence for external rotation splintage is equivocal. In the cohort of patients in whom recurrent instability is most likely, external rotation gave no additional benefit over simple immobilization in a sling.…”

Letter to the Editor

“…We applaud the efforts of this research team, as well as others [3,9] who have attempted to reproduce the results found by Itoi et al [8,10] with randomized clinical trials. However, the results of these three studies still leave questions regarding the ideal method for shoulder immobilization in this population.…”