The epidemiology of shoulder dislocations

Krøner, Karsten; Lind, T; Jensen, Jan Mick

doi:10.1007/bf00932317

Cited by 277 publications

(196 citation statements)

References 6 publications

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“…Patients in the study by Hendey and colleagues were younger with a higher proportion of recurrent dislocations than had been previously reported. 1,6,10 Hendey and coworkers' algorithm should be subject to further validation in a different population before widespread use.…”

Section: Discussionmentioning

confidence: 99%

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Refinement of the Quebec decision rule for radiography in shoulder dislocation

Émond

Sage

Lavoie

et al. 2009

CJEM

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Objective:We prospectively derived a clinical decision rule to guide pre-and postreduction radiography for emergency department (ED) patients with anterior glenohumeral dislocation. Methods: This prospective cohort derivation study took place at 4 university-affiliated EDs over a 3-year period and enrolled consenting patients with anterior glenohumeral dislocation who were 18 years of age or older. We compared patients with a clinically important fracture-dislocation with those who had an uncomplicated dislocation to provide the clinical decision rule components using recursive partitioning. The final rule involved age, mechanism, prior dislocation and humeral ecchymosis. Results: A total of 222 patients were included in the study. Forty (18.0%) had clinically important fracture-dislocation. A clinical decision rule using 4 factors reached a sensitivity of 100% (95% confidence interval [CI] 89.4%-100%), a specificity of 34.2% (95% CI 27.7%-41.2%), a negative predictive value of 99.2% (95% CI 92.8%-99.9%) and a negative likelihood ratio of 0.04 (95% CI 0.002-0.27). Patients younger than 40 years are at high risk for clinically important fracturedislocation only if the mechanism of injury involves substantial force (i.e., a fall greater than their own height, a sport injury, an assault or a motor vehicle collision). Patients 40 years of age or older are at high risk only in the presence of humeral ecchymosis or after their first dislocation. Projected use of the rule would reduce the absolute number of prereduction radiographs by 27.9% and of postreduction by 81.9%. Conclusion: The Quebec shoulder dislocation rule for patients with acute anterior glenohumeral dislocation holds promise to reduce unnecessary imaging, pending validation. RÉSUMÉObjectif : Notre étude visait à établir de façon prospective une règle de décision clinique afin de guider le recours aux radiographies précédant et suivant la réduction chez les patients se présen-tant à l'urgence avec une luxation glénohumérale antérieure. Méthode : Cette étude de dérivation sur une cohorte prospective s'est déroulée sur une période de 3 ans, dans 4 services d'urgence d'hôpitaux universitaires. Nous avons inscrit des patients consentants de 18 ans ou plus qui présentaient une luxation glénohumérale antérieure. Nous avons comparé les patients ayant une luxation ou une fracture cliniquement importante avec ceux qui avaient une luxation sans complication en vue d'établir les critères d'une règle de décision clinique ORIGINAL RESEARCH • RECHERCHE ORIGINALE EM ADVANCES

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Section: Discussionmentioning

confidence: 99%

“…Glenohumeral dislocation is an important cause of shoulder injuries seen in the emergency department (ED) 1,2 and is the most frequent type of dislocation reduced by emergency physicians (EPs). 3 Prereduction radiography of the shoulder is generally advocated to confirm the diagnosis and to identify any associated fracture.…”

Section: Introductionmentioning

confidence: 99%

Refinement of the Quebec decision rule for radiography in shoulder dislocation

Émond

Sage

Lavoie

et al. 2009

CJEM

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“…A luxação glenoumeral é a luxação articular mais comum do corpo humano (12) . Existe um grande número de técnicas para redução da luxação anterior do ombro.…”

Section: Discussionunclassified

Estudo transversal sobre os diferentes métodos de tratamento das luxações traumáticas glenoumerais: a cross-sectional study

Wajnsztejn¹,

Tamaoki²,

Netto³

et al. 2009

Rev. bras. ortop.

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rEsUMOObjetivo: Verificar como uma população de ortopedistas brasileiros trata a luxação glenoumeral traumática e comparar com os conceitos mais recentes estabelecidos pela literatura. Mé-todos: Foram distribuídos 200 questionários com 13 questões objetivas sobre a abordagem terapêutica da luxação traumática glenoumeral; 158 foram preenchidos corretamente e aceitos para este estudo. Resultados: A manobra preferida pela maioria foi tração e contratração (60,8%). Dentre os entrevistados, 68,4% declararam obter a redução da luxação glenoumeral na primeira tentativa em mais de 90% dos casos. A primeira tentativa de redução ocorre predominantemente no pronto-socorro (96,5%). Setenta e nove (50,0%) indivíduos relataram não usar nenhuma analgesia antes da redução. A maioria dos participantes imobiliza seus pacientes após a redução (98,1%); desses, 75,4% mantêm seus pacientes imobilizados por duas a três semanas. Conclusões: De forma geral, o ortopedista brasileiro realiza a redução da luxação glenoumeral com a manobra de tração e contratração. Obtém a redução na primeira tentativa em mais de 90% dos casos e realiza a redução no pronto-socorro. Não utiliza nenhuma analgesia previamente à redução. Imobiliza o paciente com tipoia toracobraquial ou tipoia simples por duas a três semanas. descritores -

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“…1 Acute shoulder dislocation is a surgical emergency and demands urgent relocation. 2 The patient with an acute shoulder dislocation is usually distressed, in severe pain, and unable to move the affected shoulder.…”

Section: Introductionmentioning

confidence: 99%

An audit on the management of patients with acute shoulder dislocation

Chan¹

2010

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Acute shoulder dislocation is a common presenting complaint to the emergency department. Acute shoulder dislocation is a surgical emergency and demands urgent relocation. The aims of the audit were to assess the current performance in the management of patients with acute shoulder dislocation in relation to standards set by the College of Emergency Medicine (CEM). These standards relate to prompt administration of analgesia, diagnosis, and attempt at shoulder reduction. A retrospective audit was carried out at a district general hospital and identified 76 patients presenting with acute shoulder dislocation over a 6-month period. The results showed that patient care could be improved in relation to administration of analgesia and through earlier attempt at shoulder reduction. By suspecting a dislocated shoulder, the triage nurse has the potential to expedite the appropriate investigations and initiate the appropriate management. Through departmental training and the introduction of a management protocol, the treatment of such patients can be optimized.

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The epidemiology of shoulder dislocations

Cited by 277 publications

References 6 publications

Refinement of the Quebec decision rule for radiography in shoulder dislocation

Refinement of the Quebec decision rule for radiography in shoulder dislocation

Estudo transversal sobre os diferentes métodos de tratamento das luxações traumáticas glenoumerais: a cross-sectional study

An audit on the management of patients with acute shoulder dislocation

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