Abstract
Traumatic dislocations of the shoulder commonly present to emergency departments (EDs). Immediate closed reduction of both anterior and posterior glenohumeral dislocations is recommended and is frequently performed in the ED. Recurrence of dislocation is common, as anteroinferior labral tears (Bankart lesions) are present in many anterior shoulder dislocations.14,15,18,23 Immobilization of the shoulder following closed reduction is therefore recommended; previous studies support the use of immobilization with the shoulder in a position of external rotation, for both anterior and posterior shoulder dislocations.7–11,19 In this study, we present a technique for assembling a low-cost external rotation shoulder brace using materials found in most hospitals: cotton roll, stockinette, and shoulder immobilizers. This brace is particularly suited for the uninsured patient, who lacks the financial resources to pay for a pre-fabricated brace out of pocket. We also performed a cost analysis for our low-cost external rotation shoulder brace, and a cost comparison with pre-fabricated brand name braces. At our institution, the total materials cost for our brace was $19.15. The cost of a pre-fabricated shoulder brace at our institution is $150 with markup, which is reimbursed on average at $50.40 according to our hospital billing data. The low-cost external rotation shoulder brace is therefore a more affordable option for the uninsured patient presenting with acute shoulder dislocation.
Highlights
The acute traumatic shoulder dislocation is a frequent reason for presentation to emergency departments (EDs)
We present a technique for assembling a low-cost external rotation shoulder brace using materials found in most hospitals: cotton roll, stockinette, and shoulder immobilizers
Our hospital is contracted with DJO Global (Vista, CA) for the Donjoy® UltraslingTM shoulder braces; price for the braces with mark-up included at our institution was $150 per brace; Medicare reimbursement for each brace was quoted at $50.40, as only roughly one-third of the total cost is reimbursed to the hospital
Summary
The acute traumatic shoulder dislocation is a frequent reason for presentation to emergency departments (EDs). TECHNIQUE The low-cost external rotation shoulder brace consists of four components: the waist strap, the arm strap, the wrist strap, and the external rotation bump (Figure 1, Video). Materials for the external rotation shoulder brace include: two 14” practical cotton rolls, four feet of 4” stockinette roll (Figure 2), two standard shoulder immobilizer sets. A waist strap from the first shoulder immobilizer set is cut to size, wrapped around the cotton-stuffed stockinette, and fastened. This serves as the external rotation bump (Figure 5). Prefabricated shoulder brace was 4.6 times that of the total materials cost of our brace
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
