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Non-operative treat...
Non-operative treatment of primary anterior shoulder dislocation in patients forty years of age and younger : a prospective twenty-five-year follow-up
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- Hovelius, Lennart (author)
- Department of Orthopedics, Gävle Hospital, S-801 87 Gävle, Sweden
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- Olofsson, Anders (author)
- Department of Orthopedics, Gävle Hospital, S-801 87 Gävle, Sweden
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- Sandström, Björn (author)
- Sandström, B., Department of Orthopedics, Gävle Hospital, S-801 87 Gävle, Sweden
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- Augustini, Bengt-Göran (author)
- Läkargruppen AB, Box 344, S-70146 Örebro, Sweden
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- Krantz, Lars (author)
- Orthopedic Department, Högalidssjukhuset, S-5758 Eksjö, Sweden
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- Fredin, Hans (author)
- Läkargruppen St Petri, Hamng 4, S-21122 Malmö, Sweden
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- Tillander, Bo (author)
- Östergötlands Läns Landsting,Linköpings universitet,Hälsouniversitetet,Ortopedi och idrottsmedicin,Ortopedkliniken Linköping
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- Skoglund, Ulf (author)
- Department of Orthopedics, Karlstad Hospital, S-65185 Karlstad, Sweden
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- Salomonsson, Björn (author)
- Karolinska Institutet
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- Nowak, Jan (author)
- Department of Orthopedics, Samariterhemmet, S-85125 Uppsala, Sweden
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- Sennerby, Ulf (author)
- Department of Orthopedics, Nordfjord Hospital, N-6771 Nordfjord, Norway
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Department of Orthopedics, Gävle Hospital, S-801 87 Gävle, Sweden Sandström, B, Department of Orthopedics, Gävle Hospital, S-801 87 Gävle, Sweden (creator_code:org_t)
- Journal of Bone and Joint Surgery, 2008
- 2008
- English.
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In: Journal of Bone and Joint Surgery. American volume. - : Journal of Bone and Joint Surgery. - 0021-9355 .- 1535-1386. ; 90:5, s. 945-952
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Abstract
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- Background: During 1978 and 1979, we initiated a prospective multicenter study to evaluate the results of nonoperative treatment of primary anterior shoulder dislocation. In the current report, we present the outcome after twenty-five years.Methods: Two hundred and fifty-five patients (257 shoulders) with an age of twelve to forty years who had a primary anterior shoulder dislocation were managed with immobilization (achieved by tying the arm to the torso with use of a bandage) or without immobilization. All 227 living patients (229 shoulders) completed the follow-up questionnaire, and 214 patients completed the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire.Results: Ninety-nine (43%) of 229 shoulders had not redislocated, and seventeen (7%) redislocated once. Thirty-three recurrent dislocations had become stable over time (14.4%), and eighteen were considered to be still recurrent (7.9%). Sixty-two shoulders (27%) had undergone surgery for the treatment of recurrent instability. Immobilization after the primary dislocation did not change the prognosis. Only two of twenty-four shoulders with a fracture of the greater tuberosity at the time of the primary dislocation redislocated (p < 0.001). When shoulders with a fracture of the greater tuberosity were excluded, forty-four (38%) of 115 shoulders in patients who had been twelve to twenty-five years of age at the time of the original dislocation and sixteen (18%) of ninety shoulders in patients who had been twenty-six to forty years of age had undergone surgical stabilization. At twenty-five years, fourteen (23%) of sixty-two shoulders that had undergone surgical stabilization were in patients who subsequently had a contralateral dislocation, compared with seven (7%) of ninety-nine shoulders in patients in whom the index dislocation had been classified as solitary (p = 0.01). Gender and athletic activity did not appear to affect the redislocation rate; however, women had worse DASH scores than men did (p = 0.006).Conclusions: After twenty-five years, half of the primary anterior shoulder dislocations that had been treated nonoperatively in patients with an age of twelve to twenty-five years had not recurred or had become stable over time.Level of Evidence: Prognostic Level I. See Instructions to Authors for a complete description of levels of evidence.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Ortopedi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Orthopaedics (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kirurgi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Surgery (hsv//eng)
Keyword
- arthroscopic stabilization
- prognosis
- instability
- immobilization
- disabilities
- adults
- arm
- MEDICINE
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Hovelius, Lennar ...
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Olofsson, Anders
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Sandström, Björn
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Augustini, Bengt ...
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Krantz, Lars
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Fredin, Hans
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Tillander, Bo
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Skoglund, Ulf
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Salomonsson, Bjö ...
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Nowak, Jan
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Sennerby, Ulf
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Orthopaedics
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Surgery
- Articles in the publication
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Journal of Bone ...
- By the university
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Umeå University
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Linköping University
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Karolinska Institutet