PURPOSE To determine if immobilization in external rotation would decrease recurrence rates of anterior shoulder dislocations. The hypothesis was based on the observation that external rotation will tighten the anterior glenohumeral joint capsule and subscapularis tendon which causes the labrum to be forced back into position on the glenohumeral rim²

METHODS From January 2000 – March 2002 first-time anterior dislocators of the glenohumeral joint were enrolled. After the shoulder was reduced they were randomly assigned to the internal immobilization (n=20) or external immobilization at 10-15° of external rotation (n=20). Average follow up was 15.9 months (IR group) and 13.7 months (ER group).

Internal Immobilization Group
External Immobilization Group

Overall Recurrence Rate
6/20 (30%)
0/20 [0%)

Recurrence Rate in
Patients > 29
5/11 (45%)
0/11 (0%)

Anterior Apprehension Sign Positive
2/14 (14%)
1/5 (5%)

CONCLUSION: This study demonstrated that immobilization of patients in external rotation after first-time shoulder dislocation had lower recurrence rates than patients immobilized in internal rotation.

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