Surgical versus conservative treatment for acute first-time anterior shoulder dislocation: the evidence

Abstract

Acute anterior dislocation of the shoulder is a common injury associated with a high rate of recurrence in young active men. Management of traumatic anterior shoulder dislocation aims to restore range of motion, to reduce the risk of recurrence and to assure an improved quality of life with a stable and painless shoulder. It includes conservative and surgical-open or arthroscopic treatment, followed by rehabilitation. No clear consensus has been reached on the best management, surgical or conservative, to adopt in first-time anterior shoulder dislocation. The aim of this review was to collect and evaluate the scientific evidence supporting the effectiveness of immediate surgical treatment versus immobilization and rehabilitation for first-time traumatic anterior shoulder dislocation. There is some evidence to support primary surgery in young active patients with an acute first traumatic shoulder dislocation, in order to reduce the risk of recurrence, but there is no evidence for the best surgical technique or best conservative approach, nor is there information regarding the best treatment in other categories of patients.