Questionnaire reveals variations in the management of acute first time shoulder dislocations in the Netherlands.
OBJECTIVE
To collect information about the management of patients with acute first time shoulder dislocation by (orthopaedic) surgeons in the accident and emergency departments of Dutch hospitals.


METHODS
Questionnaires were sent to 131 (orthopaedic) surgeons of 74 Dutch hospitals.


METHODS
We enquired whether patients with acute first time shoulder dislocation are managed according to protocols in accident and emergency departments; which radiographs are deemed necessary before and after reduction; which reduction methods are generally performed; and what kind of pain relief or sedatives are generally administered. Furthermore, we enquired into the method and duration of immobilization after reduction.


RESULTS
The response rate was 73%. Sixty-five per cent of the hospitals are used to managing acute first time shoulder dislocation according to protocols. Making prereduction and postreduction radiographs is standard practice in almost all hospitals. The most favoured methods of reduction are those according to Kocher and Hippocrates. In 85% of cases sedatives are administered before reduction, and in addition to that systemic analgesia is administered in 30%, whereas intra-articular analgesia is preferred in 25% of cases.


CONCLUSIONS
Apparently, a protocol for the management of acute first time shoulder dislocation is not standardly available in all hospitals. On the basis of current literature and the results of this questionnaire it may be useful to establish a guideline for diagnostic procedures and the management of acute first time shoulder dislocation in accident and emergency departments.
te Slaa
Ron L
RL
Department of Orthopaedics and Traumatology, Reinier de Graaf Hospital, Delft, the Netherlands. rlteslaa@wanadoo.nl
Wijffels
Marcus P J M
MP
Marti
Rene K
RK
D000208:Acute Disease; D000328:Adult; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D019637:Orthopedic Procedures / Q000706:statistics & numerical data; D009985:Orthopedics / Q000706:statistics & numerical data*; D012783:Shoulder Dislocation / Q000453:epidemiology / Q000628:therapy*; D011795:Surveys and Questionnaires