Post-reduction: Immobilisation in External Versus Internal Rotation
For thousands of years, treatment of anterior shoulder dislocation has included immobilisation of the patient's arm in a sling, with the arm placed in internal rotation (across the body). However, three studies, one in cadavers and two in patients, suggest that the detachment of the structures in the front of the shoulder is made worse when the shoulder is placed in internal rotation to be seen. By contrast, the structures are realigned when the arm is placed in external rotation. New data suggest that if the shoulder is managed non-operatively and immobilised, it should be immobilised in a position of external rotation.
Another study found that conventional shoulder immobilisation in a sling offered no benefit.
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