Natural history of glenohumeral dislocation--revisited

The purpose of this study was to evaluate the natural history of glenohumeral dislocation in young athletes. A review of the literature revealed a consensus of opinion that the dislocated shoulder should be immobilized from 3-6 weeks. However, a high recurrence rate could be expected. One hundred twenty-one patients with acute traumatic anterior dislocations were evaluated (average age-19 years). Methods of immobilization were shoulder immobilizers and slings and swaths. Sixty-two patients were immobilized and 56 (90%) of these suffered recurrent dislocation. Fifty-nine patients were not immobilized and 50 (85%) re-dislocated their shoulders. The length of immobilization had no effect on the recurrence rate. All re-dislocations occurred within 18 months of the initial injury. Seventy-nine patients were operated on for recurrent dislocation. With such a high recurrence rate in the athletic age group, the authors question if immobilization affects the prognosis.