[Abduction/external rotation immobilization after primary traumatic anterior shoulder dislocation: which ortheses are suitable?].
BACKGROUND
Immobilization of the shoulder in 60 ° external rotation and 30 ° abduction after primary anterior shoulder dislocation has been shown to allow anatomical reduction and potential healing of the capsule-labrum complex. The purpose of the present study was to evaluate commercially available shoulder braces concerning functionality and comfort as well as for potential problems.


METHODS
In this study ten healthy subjects (6 female, 4 male and average age 23 years) tested four braces: 1. Omo Immobil (Ottobock), 2. Quadrat (DJO Global), 3. MP Airplane Axilla (Horst Rattenhuber GmbH) and 4. ARC XR (Bledsoe Brace Systems) with respect to functionality and comfort. Each subject completed simulated activities of daily living (ADLs) and a the end of each ADL the subject evaluated comfort, difficulty of the activities and potential pain on a points scale. The position or the change of the position were controlled by digital photographs. Additionally it was checked whether the subjects could actively change the position of the brace contrary to the desired position.


RESULTS
Braces 3 and 4 were rated significantly more comfortable (p < 0.05). Even the difficulty of the activities was rated lower and in particular putting on and taking off the braces was assessed to be significantly easier in comparison to braces 1 and 2. In addition, differences of potential pain were statistically significant and pain was experienced only with braces 1 and 2. The measuring of the position showed no significant differences (p > 0.05). For braces 1 and 2 the active change of the position by subjects was significantly higher and the arm could be rotated more against the favored position (p < 0.05). Between braces 3 and 4, there were no statistical differences during the whole evaluation.


CONCLUSIONS
Ortheses where the main joint is positioned in and not in front of the axilla or which can ensure a jointless stabilization of the shoulder or which allow an improved position by an additional sling on the opposite shoulder, are most qualified for immobilization of the shoulder in an external rotation/abduction position with respect to functionality and comfort.
Centrum für Muskuloskeletale Chirurgie (CMSC), Charité Universitätsmedizin Berlin, Campus-Virchow und Campus Mitte, Augustenburger Platz 1, 13353, Berlin, Deutschland.
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Thierbach
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Le
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Uecker
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Gerhardt
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Scheibel
D001915:Braces; D019544:Equipment Failure Analysis; D005260:Female; D006801:Humans; D007103:Immobilization / Q000295:instrumentation* / Q000379:methods; D008297:Male; D017060:Patient Satisfaction; D011474:Prosthesis Design; D017755:Prosthesis Fitting / Q000379:methods; D016059:Range of Motion, Articular; D012783:Shoulder Dislocation / Q000175:diagnosis* / Q000628:therapy*; D013673:Technology Assessment, Biomedical; D016896:Treatment Outcome; D055815:Young Adult