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Journal of Bone and Joint Surgery - British Volume, Vol 91-B, Issue 7, 918-921.
doi: 10.1302/0301-620X.91B7.22263  
Copyright © 2009 by British Editorial Society of Bone and Joint Surgery
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Bracing in external rotation for traumatic anterior dislocation of the shoulder

A. Finestone, MD, Orthopaedic Surgeon1; C. Milgrom, MD, Professor2; D. R. Radeva-Petrova, MPH, Clinical Research Assistant2; E. Rath, MD, Orthopaedic Surgeon3; V. Barchilon, MD, Orthopaedic Surgeon4; S. Beyth, MD, Orthopaedic Surgeon2; S. Jaber, MD, Orthopaedic Surgeon2; and O. Safran, MD, Orthopaedic Surgeon2

1 Assaf HaRofeh Medical Centre, Zerrifin, Beer Yaakov 70300, Israel.
2 Department of Orthopaedics Hadassah University Hospital, Ein Kerem, P. O. Box 12000, Jerusalem, Israel.
3 Soroka Hospital, Ben Gurion University Medical School, POB151 Beersheva 84141, Israel.
4 Meir Hospital, Sapir Medical Centre, Tchernitiovsky 59, Kfar Sava 44281, Israel.

Correspondence should be sent to Professor C. Milgrom; e-mail: charlesm{at}ekmd.huji.ac.il

We undertook a prospective study in 51 male patients aged between 17 and 27 years to ascertain whether immobilisation after primary traumatic anterior dislocation of the shoulder in external rotation was more effective than immobilisation in internal rotation in preventing recurrent dislocation in a physically active population.

Of the 51 patients, 24 were randomised to be treated by a traditional brace in internal rotation and 27 were immobilised in external rotation of 15° to 20°. After immobilisation, the patients undertook a standard regime of physiotherapy and were then assessed clinically for evidence of instability. When reviewed at a mean of 33.4 months (24 to 48) ten from the external rotation group (37%) and ten from the internal rotation group (41.7%) had sustained a futher dislocation. There was no statistically significant difference (p = 0.74) between the groups.

Our findings show that external rotation bracing may not be as effective as previously reported in preventing recurrent anterior dislocation of the shoulder.






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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General