From the Research
The recommended immobilization period for a shoulder following dislocation and reduction is typically 1-3 weeks, with most current protocols favoring shorter durations, and immobilization in external rotation is recommended to reduce the recurrence rate and prevent complications. The position of immobilization is evolving, with some evidence suggesting external rotation immobilization may be more effective for anterior dislocations, as shown in a meta-analysis of randomized controlled trials 1. This study found that external rotation immobilization significantly reduced the recurrence rate compared with internal rotation immobilization, with a risk ratio of 0.56 (P = .007) 1. Another study also found that external rotation immobilization reduces the recurrence rate after primary shoulder dislocation compared with internal rotation immobilization in patients older than 20 years 2. Some key points to consider when immobilizing a shoulder after dislocation include:
- Immobilization in external rotation is recommended to reduce the recurrence rate and prevent complications 1, 2
- The duration of immobilization is typically 1-3 weeks, with most current protocols favoring shorter durations
- Gentle finger, wrist, and elbow exercises should be performed during immobilization to prevent stiffness in these joints
- A structured rehabilitation program focusing on rotator cuff strengthening and scapular stabilization should begin after the immobilization period. It's worth noting that the evidence from older studies, such as the 2010 systematic review and meta-analysis, suggested that there is no benefit of conventional sling immobilization for longer than one week for the treatment of primary anterior shoulder dislocation in younger patients 3. However, the more recent and higher-quality studies, such as the 2020 meta-analyses, provide stronger evidence for the use of external rotation immobilization to reduce recurrence rates 1, 2.