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Measuring 3D In-vivo Shoulder Kinematics using Biplanar Videoradiography

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Published on: March 12, 2021

Do all patients with shoulder dislocations need prereduction x-rays?

Joseph Orloski¹, Barnet Eskin, Paul C Allegra

¹Morristown Memorial Residency in Emergency Medicine, Morristown Memorial Hospital, NJ 07960, USA. jlo24@cornell.edu

The American Journal of Emergency Medicine

|September 10, 2010

Summary

This summary is machine-generated.

Routine prereduction x-rays may be unnecessary for young adults with shoulder dislocations. Patients in their second and third decades of life have a fracture risk below 1%, potentially reducing imaging needs.

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Area of Science:

Orthopedic Surgery
Emergency Medicine
Radiology

Background:

Prereduction imaging for shoulder dislocations is standard practice.
The necessity of routine imaging, particularly x-rays, is debated.
Fracture incidence varies significantly with patient age.

Purpose of the Study:

To determine the age-specific incidence of fractures in patients with shoulder dislocations.
To identify age groups with a sufficiently low fracture risk to potentially forgo routine prereduction x-rays.
To inform clinical guidelines on imaging protocols for shoulder dislocations.

Main Methods:

Retrospective cohort study utilizing ICD-9 codes from 19 EDs in NJ and NY.
Identified patients with shoulder dislocations and co-occurring fractures.
Analyzed fracture prevalence stratified by decade of life.

Main Results:

Of 7209 dislocations, 6.5% had associated fractures.
The lowest fracture rates were observed in the 2nd (0.7%) and 3rd (0.8%) decades of life.
Fracture rates increased with age, exceeding 19% in the 8th-10th decades; omitting x-rays in the 2nd/3rd decades could reduce imaging by 40%.

Conclusions:

Patients in the second and third decades of life with shoulder dislocations have a fracture risk below 1%.
Routine prereduction x-rays may not be necessary for this demographic.
Age-based imaging protocols could optimize resource utilization and reduce patient exposure.