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How long should we immobilize a shoulder after dislocation?
 

The DonJoy Ultrasling ER 30° was tested using 22 patients with traumatic antero-inferior dislocation of the glenohumeral joint. The study published in the American Journal of Sports Medicine in March 2009 wanted to assess position, reduction and mobility of the displaced antero-inferior labrum over varying lengths of immobilization.

Immobilization of the shoulder in external rotation has been shown to reduce the risk of recurrence after traumatic antero-inferior shoulder dislocation, but it remains unclear how duration of immobilization affects labral coaptation.

Using the 30° wedge with the DonJoy Ultrasling ER 30°, a higher degree of external rotation can be achieved compared to other orthoses. This method seems to be beneficial in terms of labral coaptation and perhaps soft tissue healing.

To test for optimum length of immobilization the 22 patients were divided into two groups: one group was immobilized for three weeks while the other group for five weeks, both in 30° of external rotation.

Ultrasling ER 30°

Would a longer immobilisation period prove more effective?

MRI evaluation during the acute phase showed significantly less displacement and separation of the labrum and significantly less joint effusion with maximum external rotation compared with neutral and internal rotation. These findings were similar in both groups and suggest an improved labral coaptation due to tensioning of the anterior soft tissue structures.

After five weeks there appeared to be no significant differences in any parameters when comparing internal rotation, neutral rotation, 30° external rotation or maximum external rotation. This suggested a stable position for the antero-inferior labrum from internal rotation to external rotation.

When comparing the results of the measured variables during the acute, 3-week and 5-week MRI examinations, there was a significant improvement of the parameters throughout the 5-week follow-up period in both groups. There were no significant differences between the groups, suggesting that a prolonged immobilisation up to five weeks may not be necessary to achieve stable and more anatomical position of the labrum.

In conclusion, the study suggests that immobilization of the shoulder in 30° external rotation using the DonJoy Ultrasling ER 30°, results in similar coaptation of the glenoid labrum regardless of the time immobilized.

The next step is for clinical trails to ascertain the optimum position of immobilization in external rotation.

For more details follow the link from MyDJO.

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