title: Effectiveness of external rotation immobilization in highly active young men with traumatic primary anterior shoulder dislocation or subluxation.
abstract: We treated 15 highly active young men (16 shoulders) with traumatic primary anterior shoulder dislocation or subluxation using 3-week external rotation immobilization. Fourteen patients (14 shoulders) were members of the Self-Defense Force and the other patient (2 shoulders) was a high school student who played club-level rugby. Average patient age at the time of the primary injury was 21.3 years (range, 17-26 years). Magnetic resonance imaging (MRI) was performed on 14 of 16 shoulders after the 3-week external rotation immobilization and showed that the anteroinferior labrum was reduced on the glenoid rim in 11 shoulders but remained medially displaced on the glenoid neck in 3 shoulders. Five shoulders, including these 3 shoulders, underwent arthroscopic Bankart repair after 3-week external rotation immobilization. Eleven shoulders continued nonoperative treatment after the immobilization. Four of 11 shoulders had no recurrence of symptoms for >2 years, and these patients were able to return to their preinjury activities. However, 7 shoulders experienced recurrence within 2 years. We concluded that external rotation immobilization may not be as effective as mentioned previously in highly active young men with primary traumatic anterior shoulder dislocation or subluxation. Whether a patient has instability symptom recurrence after external rotation immobilization depends on more than the fact that the anteroinferior labrum is not reduced on MRI.
authors.affiliation: Department of Orthopedic Surgery, Japan Self Defense Force, Sapporo General Hospital, Sapporo, Japan. yoshi1869@paw.hi-ho.ne.jp
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Tanaka
authors.forename: Kenji
authors.initials: K
authors.lastname: Okamura
authors.forename: Tomohito
authors.initials: T
authors.lastname: Imai
mesh_terms: D000293:Adolescent; D000328:Adult; D001182:Arthroscopy; D001915:Braces; D005538:Football; D006801:Humans; D007103:Immobilization; D008279:Magnetic Resonance Imaging; D008297:Male; D008889:Military Personnel; D020127:Recovery of Function; D012008:Recurrence; D012189:Retrospective Studies; D012399:Rotation; D012783:Shoulder Dislocation / Q000473:pathology / Q000628:therapy*; D012785:Shoulder Joint / Q000473:pathology / Q000601:surgery; D016896:Treatment Outcome; D055815:Young Adult