THE UK SHOULDER SURGEON’S APPROACH TO TRAUMATIC, ANTERIOR SHOULDER DISLOCATION IN THE YOUNG PATIENT.

M Freudmann; S Hay

doi:10.1302/0301-620X.86BSUPP_I.0860098c

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THE UK SHOULDER SURGEON’S APPROACH TO TRAUMATIC, ANTERIOR SHOULDER DISLOCATION IN THE YOUNG PATIENT.

M Freudmann
S Hay

THE UK SHOULDER SURGEON’S APPROACH TO TRAUMATIC, ANTERIOR SHOULDER DISLOCATION IN THE YOUNG PATIENT.

Freudmann M, Hay S. THE UK SHOULDER SURGEON’S APPROACH TO TRAUMATIC, ANTERIOR SHOULDER DISLOCATION IN THE YOUNG PATIENT.. Orthop Procs. 2004;86-B(SUPP_I):98-98. doi:10.1302/0301-620X.86BSUPP_I.0860098c

Freudmann, M, and S Hay. “THE UK SHOULDER SURGEON’S APPROACH TO TRAUMATIC, ANTERIOR SHOULDER DISLOCATION IN THE YOUNG PATIENT..” Orthopaedic Proceedings, vol. 86-B, no. SUPP_I, 2004, pp. 98-98., https://doi.org/10.1302/0301-620X.86BSUPP_I.0860098c

Freudmann, M., & Hay, S. (2004). THE UK SHOULDER SURGEON’S APPROACH TO TRAUMATIC, ANTERIOR SHOULDER DISLOCATION IN THE YOUNG PATIENT.. Orthopaedic Proceedings, 86-B(SUPP_I), 98-98. https://doi.org/10.1302/0301-620X.86BSUPP_I.0860098c

Freudmann, M. and Hay, S. (2004) “THE UK SHOULDER SURGEON’S APPROACH TO TRAUMATIC, ANTERIOR SHOULDER DISLOCATION IN THE YOUNG PATIENT..” Orthopaedic Proceedings, 86-B(SUPP_I), pp. 98-98. Available at: https://doi.org/10.1302/0301-620X.86BSUPP_I.0860098c

Freudmann, M, and S Hay. “THE UK SHOULDER SURGEON’S APPROACH TO TRAUMATIC, ANTERIOR SHOULDER DISLOCATION IN THE YOUNG PATIENT..” Orthopaedic Proceedings 86-B, no. SUPP_I (2004): 98-98. https://doi.org/10.1302/0301-620X.86BSUPP_I.0860098c

Freudmann M, Hay S. THE UK SHOULDER SURGEON’S APPROACH TO TRAUMATIC, ANTERIOR SHOULDER DISLOCATION IN THE YOUNG PATIENT.. Orthop Procs. 2004 Jan 1;86-B(SUPP_I):98-98. https://doi.org/10.1302/0301-620X.86BSUPP_I.0860098c

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Abstract

To discover how traumatic anterior shoulder dislocation in the young patient (17–25) is managed by shoulder surgeons in the UK.

A comprehensive postal questionnaire was sent to 164 orthopaedic consultants, all members of BESS. Questions were asked about the initial reduction, investigations undertaken, timing of any surgery, preferred stabilization procedure, arthroscopic or open, detail of surgical technique, period of immobilization and rehabilitation programmes instigated in first-time and recur- rent traumatic dislocaters.

The response rate was 82% (n=135)

The most likely treatment of a young traumatic shoulder dislocation:

It will be reduced under sedation in A& E by the A& E doctor.
Apart from x-ray, no investigations will be performed
It will be immobilised for 3 weeks, then given course of physiotherapy
Upon their second dislocation, they will be listed directly for an open Bankart procedure (with capsular shift as indicated) during which subscapularis will be detached and metallic bone anchors used
Following surgery, they will be immobilised for 3 to 4 weeks, before being permitted full range of movement at 2 to 3 months and allowed to return to contact sports at 6 to 12 months

On the other hand, 54% of surgeons indicated they would investigate prior to surgery, 18% said their first choice operation would be arthroscopic stabilisation, the number of dislocations normally permitted before surgery ranged from 1 to more than 4, and the period of immobilisation post operation from nil to 6 weeks.

We now know how shoulder surgeons in the UK are treating this common injury. The results reveal that in Britain, we do not have a consistent approach, raising many discussion points. Open stabilisation remains the firm favourite. Does this mean arthroscopic stabilisation is regarded as an experimental procedure?

These abstracts were prepared by Mr Cormac Kelly. Correspondence should be addressed to him c/o British Orthopaedic Association, Royal College of Surgeons, 35-43 Lincoln’s Inn Fields, London WC2A 3PN.