Outcome of Immobilization in External Rotation Position after Closed Reduction in Traumatic Anterior Shoulder Dislocation

2020 ◽  
Vol 16 (3) ◽  
Author(s):  
Suraj Bidary ◽  
Suresh Pandey ◽  
Roshani Aryal ◽  
Prabal KC ◽  
Kushal Bhattarai ◽  
...  
Keyword(s):  
Functional Outcome ◽  
Closed Reduction ◽  
Shoulder Dislocation ◽  
External Rotation ◽  
Anterior Dislocation ◽  
Anterior Shoulder Dislocation ◽  
Easy Method ◽  
Cross Sectional ◽  
Traumatic Anterior Shoulder Dislocation

Background: As documented in many studies, anterior shoulder dislocation can be effectively immobilized in both external and internal rotation positions, with favorable outcomes. However, controversy exists about the superiority of the technique of immobilization to achieve the reduced rate of redislocation. We conducted this study to assess the functional outcome of immobilization of shoulder in external rotation position after relocation in patients with acute anterior shoulder dislocation. Methods: This is hospital based cross-sectional study in total of 36 patients of primary anterior dislocation of shoulder. They were managed with closed reduction and immobilization in external rotation position and followed up for up to twelve months. Functional outcome (including re-dislocation rate) during each follow-up visit was assessed by using ROWE Score. Results: The mean age of the participants was 29.6±7.9 years (range: 17-44 years). Of them, 89.9% were male; and 55.6% were involved in risky jobs. Similarly, 50% of them sustained injury due to slip and fall, 72.2% presented to the hospital within 12 hours; and 69.4% had their right side involved. All the patients were compliant with treatment regime; 77.8% tolerated the brace well and the redislocation rate was 8.3%. ROWE score was found to be significantly increased between subsequent follow-up visits (p<0.05), except between six months and 12 months (p>0.05). Overall, ROWE score varied significantly across the total follow-up period (p<0.05). Conclusions: Immobilization in external rotation position in traumatic anterior shoulder dislocation was a simple and easy method of conservative treatment with good patient compliance, less incidence of re-dislocation and good functional outcome.

scholarly journals Recurrent anterior shoulder dislocation with glenoid fracture managed by modified Boytchev procedure: a rare case report

2019 ◽  
Vol 5 (5) ◽  
pp. 958
Author(s):  
Ashish Devgan ◽  
Umesh Yadav ◽  
Rajesh Rohilla ◽  
Pankaj Sharma ◽  
Varun Goel ◽  
...  
Keyword(s):  
Shoulder Dislocation ◽  
Full Range ◽  
Anterior Dislocation ◽  
Bone Block ◽  
Anterior Shoulder Dislocation ◽  
Glenoid Fracture ◽  
Rare Case Report ◽  
Muscle Actions ◽  
Recurrent Anterior Dislocation

<p class="abstract">Surgical procedures for recurrent anterior dislocation of the shoulder include using capsuloligamentous or bone blocks to create barriers and active interventions using muscle actions. Fracture of glenoid acts as a barrier for bone block procedures. Boytchev procedure, though outmoded, yet acts as simple and effective procedure in this condition. Here we report a 44 year old male with recurrent anterior dislocation with glenoid fracture treated by Boytchev procedure. The patient is on regular follow up since 3 years with no episode of shoulder dislocation till now with full range of movements. To conclude, Boytchev procedure is technically simple and effective method in patients with recurrent anterior shoulder dislocation with fracture of glenoid.</p>

scholarly journals The Efficacy of External Rotation Method for The Reduction of Acute Anterior Shoulder Dislocation With and Without Greater Tuberosity Fracture

2018 ◽  
Vol 3 (2) ◽  
pp. 408-412 ◽  
Author(s):  
Gopal Prasad Gnawali ◽  
Indra Dhakal ◽  
Kishor Khatri ◽  
Shanta Sharma
Keyword(s):  
Shoulder Dislocation ◽  
External Rotation ◽  
Reduction Process ◽  
Anterior Dislocation ◽  
Emergency Setting ◽  
Anterior Shoulder Dislocation ◽  
Greater Tuberosity ◽  
Rotation Method ◽  
Cause Of Failure ◽  
Successful Reduction

Introduction: Several methods of reduction technique have been described for the anterior dislocation of shoulder but none technique is said to be ideal. The aim of this study was to show the efficacy of external rotation method which could be safe and painless method for the reduction of the acute anterior shoulder dislocation with or without fracture of the greater tuberosity and to search the cause of failure of reduction.Objective: Objective of this study was to assess the efficacy of the external rotation method for reduction of acute anterior shoulder dislocation and to find the cause of failure of reduction.Methodology: All cases of anterior dislocation encountered in emergency department reduced by external rotation method by consultant orthopedic surgeon using basic emergency setting for resuscitation were included in the study. Fifty cases of shoulder dislocation was treated by this method and prospective evaluation done with regard to type of dislocation, the effectiveness of the procedure in achieving reduction, the need for pre-medication, the ease of performing reduction and complication if any.Results: Out of 50 cases, successful reduction was achieved in 42 patients. Premedication was not required in 36 successful reduction. Average time of reduction was 2 minutes in 30 patients and 5 minutes in 8 patients. Four Patients complained severe pain during reduction process. This method was not successful in 8 patients 2 of whom had displaced greater tuberosity fracture.Conclusion: The external rotation method is reliable and safe method for the reduction of acute anterior shoulder dislocation which can be performed relatively with less pain for both subcoracoid and subglenoid dislocation provided there is no displaced fracture of the greater tuberosity.  BJHS 2018;3(2)6: 408-412.

scholarly journals A simple innovative Chennai handshake technique for reducing anterior dislocation of shoulder joint: a community study of 60 cases

2017 ◽  
Vol 3 (6) ◽  
pp. 1084
Author(s):  
Muhammad Thahir ◽  
B. Suresh Gandhi ◽  
Kalaivanan Kanniyan ◽  
Shanmugasundaram .
Keyword(s):  
Shoulder Joint ◽  
Shoulder Dislocation ◽  
External Rotation ◽  
Care Center ◽  
Tertiary Care ◽  
Stage I ◽  
Stage Ii ◽  
Anterior Dislocation ◽  
Vertical Oscillation ◽  
Anterior Shoulder Dislocation

<p class="abstract"><strong>Background:</strong> Anterior shoulder dislocation is one of the commonest dislocation of our body. We here by introduce a simple, safe, successful and easily reproducible “Chennai Handshake Technique” to relocate anterior dislocation of shoulder joint.</p><p class="abstract"><strong>Methods:</strong> This method was performed by a single surgeon on sixty cases (51 males, 9 females) of anterior shoulder dislocation with a mean age of 38 years (18 to 58 years) between 2008 to 2013 in tertiary care center. Among sixty patients, there were 12 cases (20%) of fresh dislocation and 48 cases (80%) of recurrent dislocation. It comprises of holding the hand in a classical double shake position and then giving a gentle longitudinal traction (stage I) followed with slow abduction and external rotation of arm (stage II), thus reducing the shoulder dislocation. Vertical oscillation may be a part of stage II in some cases before the external rotation.<strong></strong></p><p class="abstract"><strong>Results:</strong> The index time of patient presenting to the casualty ranged from one hour to 18hrs with a mean of 4.45 hrs. The reduction time ranged  from 1 to 16 min with a mean of  5.6 min. 17 dislocations (28.3%) were reduced  during stage I. 41 dislocations (68.3%) were reduced during stage II. 5 dislocations (12.1%) needed vertical oscillation during stage II. we failed in two cases (3.3%).</p><p><strong>Conclusions:</strong> No need of assistant, no need of anesthesia, no complications makes this technique, a more look back one.</p>

LATARJET PROCEDURE FOR RECURRENT SHOULDER ANTERIOR INSTABILITY WITH LESS THAN 25% GLENOID BONE LOSS- ITS FUNCTIONAL OUTCOME: A PROSPECTIVE STUDY

2021 ◽  
pp. 62-65
Author(s):  
Arun Kumar KV ◽  
Arun Kumar C ◽  
Venkatachalam K ◽  
Gussain Rahul Vijay ◽  
Ashwin V Y ◽  
...  
Keyword(s):  
Bone Loss ◽  
Functional Outcome ◽  
Shoulder Dislocation ◽  
Scoring System ◽  
Index Score ◽  
Glenoid Bone Loss ◽  
Anterior Shoulder Dislocation ◽  
Latarjet Procedure ◽  
Shoulder Score

Background: Latarjet procedure for a recurrent anterior shoulder dislocation with more than 25% of bone loss is a standard treatment with good functional outcome. In glenoid bone loss < than25%, there is no concurrence in the surgery of choice between Bankart repair, Remplissage procedure and Latarjet procedure. This study is aimed to study the functional outcome following Latarjet procedure in recurrent shoulder instability in patients with < than 25% glenoid bone loss and also to assess the instability symptoms and complications following this procedure. Methods: It is a Clinical, Prospective and Observational study on thirty patients with recurrent anterior dislocation of shoulder, with less than 25% glenoid bone loss treated with Open Latarjet Procedure, at Chettinad Hospital and Research Institute, Kelambakkam, done between Jan 2017 to Dec 2020, with a minimum follow-up of atleast 1year duration. Patients were post-operatively assessed functionally using Constant shoulder score, Rowe scoring system and the Walch- Duplay index score. Clinical instability was also assessed using the Anterior Apprehension and Anterior Drawer Test. Results: In our study with thirty patients, who underwent Latarjet procedure, Functional outcome of the patients were assessed using the Constant shoulder score, Rowe scoring system and the Walch- Duplay index score. The combined average percentage of Score of Scores of the three scoring systems were 74.46% had Excellent results, 14.42% had Good and 11.12% of patients had Average or Fair results. None of the patients had any instability symptoms post-operatively at the 1year post-op follow-up. Four patients had supercial Surgical Site Infections and 2 patients had developed mild to moderate shoulder stiffness. Conclusion: The Latarjet gives conrmationally Excellent to Good functional outcome and aid in the early return to activities of daily living and a fewer failure rate. In patients with Recurrent Anterior Shoulder Dislocation, with even less than 25% Glenoid bone loss, it may be pertinent to primarily consider the osseous option of a coracoid transfer (Latarjet) rather than opt for simpler Open Bankart, Arthroscopic Bankart or an Arthroscopic Remplissage procedure alone. Thus, as a yardstick the bone loss concept, either on the Glenoidal or on the Humeral aspect, alone, need to be the deciding factor. The fact remains that in the athletic or otherwise Recurrent Anterior Shoulder Dislocators, there is also a concomitant humeral component, apart from the apparent and demonstrable Glenoid defect with the “Circle concept”.

scholarly journals Conservative management of first-time traumatic anterior shoulder dislocation

2021 ◽  
Author(s):  
Benedikt Schliemann ◽  
Marvin Minkus ◽  
Dominik Seybold ◽  
Markus Scheibel
Keyword(s):  
Conservative Management ◽  
Shoulder Dislocation ◽  
External Rotation ◽  
Young Patients ◽  
Clinical Results ◽  
Current Evidence ◽  
Anterior Shoulder Dislocation ◽  
Recurrence Rates ◽  
Traumatic Anterior Shoulder Dislocation ◽  
First Time

AbstractTraumatic anterior shoulder dislocation is a common injury in young and active patients and the proper treatment is still a matter of debate. The recurrence rate after conservative management remains high and, therefore, primary surgical intervention is sometimes recommended in very young patients whose risk of recurrences is highest. Immobilization in external rotation, first described by Itoi, is a promising conservative option as it provides adequate labral reduction and low recurrence rates. Recent meta-analyzes could not unequivocally demonstrate its superiority over internal rotation immobilization. However, biomechanical and early clinical results show a better effect on reduction of the labrum and lower recurrence rates for immobilization in a combination of abduction/external rotation than for external rotation alone. The present article aims to provide an overview of the conservative management of first-time traumatic shoulder dislocation in order to provide the treating physician or surgeon with the best current evidence as a basis for developing the appropriate treatment strategy for the patient.

scholarly journals First time traumatic anterior shoulder dislocation: Will it always result in recurrent shoulder dislocation in all patients?

2020 ◽  
Vol 27 (04) ◽  
pp. 695-699
Author(s):  
Faaiz Ali Shah ◽  
Mian Amjad Ali ◽  
Naeemullah
Keyword(s):  
Shoulder Joint ◽  
Shoulder Dislocation ◽  
Rehabilitation Program ◽  
Monthly Interval ◽  
Anterior Shoulder Dislocation ◽  
Number Of Patients ◽  
Traumatic Anterior Shoulder Dislocation ◽  
Recurrent Shoulder Dislocation ◽  
First Time

Objectives: To determine the frequency of recurrent shoulder dislocation after first time traumatic anterior shoulder dislocation treated non operatively. Study Design: Prospective observational cohort study. Setting: Department of Orthopedics and Traumatology Lady Reading Hospital Peshawar. Period: 25th May 2011 to 25th December 2018. Material & Methods: Patients of all ages and both gender with first time. Traumatic anterior shoulder dislocation meeting the inclusion criteria were included in the study. In the included subjects shoulder joint was relocated under general anesthesia and immobilized in a poly sling for four weeks followed by supervised physiotherapy and rehabilitation program without any surgical stabilization of the shoulder joint. All these patients were instructed for follow up at monthly interval or before if recurrence occurred. Results: A total of 52 patients with mean age 35±9.4 years (range 16-55 years) were enrolled in our study. Male patients were 43(82.6%) while female patients were 9(17.3%). Right sided dislocation was noted in 38(73%) and left in 14(26.9%). Recurrent shoulder dislocation was reported in 32(61.5%) patients during a minimal follow up period of three years. Most (46.8%, n=15) of the patients with recurrent shoulder dislocation were 30 years of age or below. Conclusion: First time traumatic anterior shoulder dislocation treated non operatively not always result in recurrent shoulder dislocation in all patients. However a large number of patients and particularly younger patients suffered recurrence.

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