[Immobilization by external rotation after primary traumatic shoulder dislocation]

Immobilization of the shoulder following dislocation and reduction is traditionally carried out using internal rotation braces. However, high recurrence rates of up to 96% may result depending on several concomitant intrinsic and extrinsic prognostic factors, such as age and level of physical activity. Recently, different cadaveric and radiologic studies have suggested an improved tissue apposition of the affected labroligamentous structures in a better anatomic position during external rotation of the humeral head. Recent clinical outcome studies have supported the hypothetical benefit of this immobilization technique. Significantly lower recurrent dislocation rates and a better anatomic positioning of the affected structures were observed after immobilization in external rotation compared to immobilization in internal rotation.However, the number of available studies in this respect is still limited. Further prospective evidence is therefore desirable to evaluate the contribution of exact positioning of the immobilization, influence of hemarthros and specific capsulolabral lesions to the long-term clinical and radiological outcome of this new concept of immobilization.