Comparison of Functional Outcome After 2 Weeks Immobilization Versus No Immobilization After Reduction of Acute Shoulder Dislocation

Mishkat  Ullah; Suhail  Amin; Musawir  Iqbal; Muhammad  Tufail; Asnaf  Siddique; . Khalid; Faisal  Rafique

doi:10.54112/bcsrj.v6i5.1721

Authors

Mishkat Ullah Combined Military Hospital Rawalpindi, Pakistan
Suhail Amin Army Medical Collage Rawalpindi, Pakistan
Musawir Iqbal University Hospital Waterford, Ireland
Muhammad Tufail Khyber Teaching Hospital Peshawar, Pakistan
Asnaf Siddique Type D Hospital Latambar Karak, Pakistan
. Khalid Combined Military Hospital Rawalpindi, Pakistan
Faisal Rafique Type D Hospital Latambar Karak, Pakistan

DOI:

https://doi.org/10.54112/bcsrj.v6i5.1721

Keywords:

Anterior shoulder dislocation, immobilization, early mobilization, functional outcome, Constant score, DASH score

Abstract

Acute anterior shoulder dislocation is an injury that happens mostly in people who are active and younger. After reducing the dislocation, immobilizing the joint is an accepted treatment, but the ideal time for removal is argued, since some studies report that early movement may help you recover faster. Objective: To analyze whether resting the shoulder is better than moving it after a closed reduction for first-time anterior shoulder dislocation. Methods: The study was carried out in the Orthopedic Surgery Department of CMH Rawalpindi between 15 June 2024 to 14 Feb 2025. The study grouped sixty patients into two groups. Group A was repaired and then confined to bed for two weeks; Group B was not immobilized and was encouraged to move as soon as possible. Constant-Murley and DASH scores were used to measure function at 2, 6, and 12 weeks after reducing the fracture. Results: Group B consistently had better mean scores for Constant-Murley and DASH at 6 and 12 weeks, with p < 0.01 (statistical significance). No differences in rates of redislocation were noticed between the groups. Conclusion: Early mobilization without immobilization after anterior shoulder dislocation results in superior short-term functional outcomes and may be a viable alternative to traditional immobilization.

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References

Belk, J.W., Wharton, B.R., Houck, D.A., Bravman, J.T., Kraeutler, M.J., Mayer, B., Noonan, T.J., Seidl, A.J., Frank, R.M. and McCarty, E.C., 2023. Shoulder stabilization versus immobilization for first-time anterior shoulder dislocation: a systematic review and meta-analysis of level 1 randomized controlled trials. The American Journal of Sports Medicine, 51(6), pp.1634-1643.

Minkus, M., Königshausen, M., Pauly, S., Maier, D., Mauch, F., Stein, T., Greiner, S., Moursy, M. and Scheibel, M., 2021. Immobilization in external rotation and abduction versus arthroscopic stabilization after first-time anterior shoulder dislocation: a multicenter randomized controlled trial. The American journal of sports medicine, 49(4), pp.857-865.

Martínez, R., Santana, F., Pardo, A. and Torrens, C., 2021. One versus 3-week immobilization period for nonoperatively treated proximal humeral fractures: a prospective randomized trial. JBJS, 103(16), pp.1491-1498.

Pougès, C., Hardy, A., Vervoort, T., Amouyel, T., Duriez, P., Lalanne, C., Szymanski, C., Deken, V., Chantelot, C., Upex, P. and Maynou, C., 2021. Arthroscopic Bankart repair versus immobilization for first episode of anterior shoulder dislocation before the age of 25: a randomized controlled trial. The American Journal of Sports Medicine, 49(5), pp.1166-1174.

Catapano, M., Pupic, N., Multani, I., Wasserstein, D. and Henry, P., 2022. Early functional mobilization for non-operative treatment of simple elbow dislocations: a systematic review. Shoulder & Elbow, 14(2), pp.211-221.

Hochberger, F., Wild, M.F., Heinz, T., Rudert, M. and List, K., 2024. Comparative Study on Postoperative Immobilization in Reverse Total Shoulder Arthroplasty: 4 Weeks vs. 6 Weeks of Immobilization Yields Similar Clinical and Functional Outcomes. Journal of Clinical Medicine, 13(21), p.6363.

van Delft, E.A., van Bruggen, S.G., van Stralen, K.J., Bloemers, F.W., Sosef, N.L., Schep, N.W. and Vermeulen, J., 2023. Four weeks versus six weeks of immobilization in a cast following closed reduction for displaced distal radial fractures in adult patients: a multicentre randomized controlled trial. The Bone & Joint Journal, 105(9), pp.993-999.

Sukpanichyingyong, S., Sangkomkamhang, T. and Foocharoen, T., 2023. Two-week versus four-week immobilization of stable distal radioulnar joint following surgical fixation of Galeazzi fracture-dislocations: A randomized controlled trial. Journal of Clinical Orthopaedics and Trauma, 45, p.102279.

Quadlbauer, S., Pezzei, C., Jurkowitsch, J., Kolmayr, B., Simon, D., Rosenauer, R., Salminger, S., Keuchel, T., Tichy, A., Hausner, T. and Leixnering, M., 2022. Immediate mobilization of distal radius fractures stabilized by volar locking plate results in a better short-term outcome than a five week immobilization: a prospective randomized trial. Clinical rehabilitation, 36(1), pp.69-86.

Alkhatib, N., Abdullah, A.S.A., AlNouri, M., Alzobi, O.Z.A., Alkaramany, E. and Ishibashi, Y., 2022. Short-and long-term outcomes in Bankart repair vs. conservative treatment for first-time anterior shoulder dislocation: a systematic review and meta-analysis of randomized controlled trials. Journal of Shoulder and Elbow Surgery, 31(8), pp.1751-1762.

Pincin, A., Tourtoulou, C., Pfirrmann, C., Lalioui, A., Savidan, P., Lefevre, Y., Harper, L. and Angelliaume, A., 2022. Elbow dislocation with and without an associated fracture in children: a prospective study of functional outcomes following 3 weeks of immobilization. Orthopaedics & Traumatology: Surgery & Research, p.103538.

Freehill, M.T., Murray, I.R., Calvo, E., Lädermann, A. and Srikumaran, U., 2023. Shoulder surgery postoperative immobilization: an international survey of shoulder surgeons. Biology, 12(2), p.291.

Chaudhry, Y.P., Morway, G.R., Papadelis, E.A., Doerr, N.A., Graf, K.W., Mashru, R.P., Dolch, H.J., Morway, G., Papadelis, E. and Graf Jr, K.W., 2024. Comparison of Short-Arm Immobilization and Long-Arm Immobilization in Conservatively Managed Distal Radius Fractures: A Meta-Analysis and Systematic Review. Cureus, 16(3).

Chiddarwar, V., de Zoete, R.M., Dickson, C. and Lathlean, T., 2023. Effectiveness of combined surgical and exercise-based interventions following primary traumatic anterior shoulder dislocation: a systematic review and meta-analysis. British Journal of Sports Medicine, 57(23), pp.1498-1508.