<![CDATA[Journal of Orthopaedic & Sports Physical Therapy - Kathryn L. Nagel, PT, MPT]]> http://www.jospt.org/kathrynlnagel Wed, 30 Apr 2008 09:05:25 EST 0 Prolonged Immobilization in Abduction and Neutral Rotation for a First-Episode Anterior Shoulder Dislocation http://www.jospt.org/issues/articleID.1247/article_detail.asp Kathryn L. Nagel, Gail D. Deyle
STUDY DESIGN: Case report. BACKGROUND: Patients who sustain first-episode anterior glenohumeral dislocations are at risk to develop chronic glenohumeral instability. Current treatment options after an initial anterior glenohumeral dislocation include immediate surgery, delayed surgery, or conserva­tive interventions such as immobilization and strengthening exercises. Duration of immobiliza­tion is variable among formal studies. Recent research suggests that typical immobilization positions may not allow adequate healing and in fact may promote glenohumeral joint instability. CASE DESCRIPTION: The patient was a 19-year-old male who sustained a first-episode anterior glenohumeral dislocation during athletic activity. Physical therapy management included a longer-than-typical period of immobilization and protected activity to allow for more complete healing. The shoulder abduction and neutral rotation immobilization position used with this patient may increase healing of structures that influence stability of the shoulder. OUTCOMES: At 13 weeks after the disloca­tion, the patient had full active and passive range of motion, near normal strength, and no complaints of pain or instability. At a 20-month follow-up the patient had resumed full activities of daily living including recreational sports without symptoms of instability. DISCUSSION: Conservative intervention options for first-episode anterior shoulder dislo­cations need further study. Immobilization and protected activity periods should be adequate to allow for complete healing. The optimal posi­tions for immobilization should be determined and implemented.

 

J Orthop Sports Phys Ther. 2007:37(4):192-198. doi:10.2519/jospt.2007.2393

 

KEY WORDS: Bankart lesion, glenohumeral joint, shoulder instability]]> http://www.jospt.org/issues/articleID.1247/article_detail.asp