Instability Severity Index Score Does Not Predict the Risk of Shoulder Dislocation after a First Episode Treated Conservatively.

Umile Giuseppe Longo,Gianluca Ciapini,Paolo Parchi,Vincenzo Denaro,Elisa Ferrari,Rocco Papalia,Michele Novi,Fabio Cosseddu,Michelangelo Scaglione,Sergio De Salvatore,Carlo Casciaro,Ilaria Piergentili

doi:10.3390/ijerph182212026

Abstract

The first purpose of this study was to verify the association between Instability Severity Index Score (ISIS) and Recurrent Shoulder Dislocation (RSD) after a first episode treated conservatively. The second aim is to identify the risk factors associated with RSD after a primary acute shoulder anterior dislocation treated conservatively. A total of 111 patients with first traumatic anterior shoulder dislocation treated at a single trauma centre between January 2014 and March 2016 were enrolled. The main predictive variables of risk factors and the ISIS score were calculated. Among the 85 patients included, 26 cases of RSD were observed (30.6%). Considering the whole population, no significant association between ISIS and RSD were reported. Regarding other risk factors, high-risk working activities and rotator cuff injury had a significantly higher RSD risk. Sex, dominant limb, familiar history, hyperlaxity, contact or overhead sports, competitive sport, post-reduction physiokinesitherapy, return to sports activity time, Hill-Sachs lesion, bony Bankart lesion and great tuberosity fracture did not seem to influence the risk of RSD. No correlation between ISIS score and RSD in patients treated conservatively after a first episode of shoulder dislocation were reported. The only risk factors with a significant association to RSD were high-risk working activities and rotator cuff injury.

Highlights

The shoulder is the most frequently dislocated joint in the human body
Recurrent Shoulder Dislocation (RSD) is defined according to Hobby et al as “radiological documentation of further dislocation, recurrence of dislocation by re-injury requiring manual reduction, recurrence of symptoms of the shoulder “popping out” or “slipping out” in a position of abduction and external rotation suggestive of subluxation, or symptomatic subluxation or instability preventing the return to full activity [18,19]
A cohort of 85 patients with a first episode of anterior shoulder dislocation was enrolled for this study (67 males and 18 females), with a mean age of 40 ± 14.7

Summary

Introduction

The shoulder is the most frequently dislocated joint in the human body. A complete pop out of the humeral head from the glenoid socket is defined as dislocation [1].The inability of bone and ligamentous structures of the shoulder joint to maintain the humeral head in the glenoid fossa, could cause a condition known as “shoulder instability” [2].The incidence of shoulder dislocation is estimated between 11 and 51 cases per100,000 individuals per year [3,4,5], but it is highly variable, as it depends on the population studied. The shoulder is the most frequently dislocated joint in the human body. The inability of bone and ligamentous structures of the shoulder joint to maintain the humeral head in the glenoid fossa, could cause a condition known as “shoulder instability” [2]. 100,000 individuals per year [3,4,5], but it is highly variable, as it depends on the population studied. The rate is significantly higher when considering an active population such as the military or athletes [4,5]. Immediate joint reduction and immobilization, followed by rehabilitation, is the most common conservative treatment for primary anterior dislocations. Surgical treatment is generally used in case of recurrence or chronic instability [7].

Objectives

Methods

Results

Discussion

Conclusion