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Clinically significant abnormalities in postreduction radiographs after anterior shoulder dislocation
1Department of Emergency Medicine, Valley Medical Center, Fresno, California, USA.
Annals of Emergency Medicine
|October 1, 1996
Summary
Postreduction radiographs for anterior shoulder dislocations rarely show new significant findings. Most abnormalities are visible on prereduction films, questioning the routine use of postreduction imaging.
Area of Science:
- Emergency Medicine
- Radiology
- Orthopedic Surgery
Background:
- Anterior shoulder dislocations are common emergency department presentations.
- Radiographic imaging is standard for diagnosing shoulder dislocations and associated injuries.
Purpose of the Study:
- To evaluate the incidence of clinically significant abnormalities on postreduction shoulder radiographs compared to prereduction films.
- To assess the diagnostic yield of routine postreduction imaging after anterior shoulder dislocation reduction.
Main Methods:
- Retrospective review of 131 patients with 175 anterior shoulder dislocations.
- Analysis of prereduction and postreduction shoulder radiographs.
- Radiologist re-evaluation of films blinded to initial interpretations.
Main Results:
- Three avulsion fractures (1.7%) were identified on postreduction films, but also present on prereduction films.
- Fourteen new Hill-Sachs deformities (8%) were noted.
- One case of persistent dislocation (0.6%) required further reduction; no other findings altered acute management.
Conclusions:
- Postreduction radiographs infrequently reveal new, clinically significant abnormalities after anterior shoulder dislocation reduction.
- The necessity and cost-effectiveness of routine postreduction radiographs warrant re-evaluation.
- Further prospective studies are recommended to validate these findings.