A Clinical Overview of Management of First time Anterior Shoulder Dislocation

Abstract

Background: Instability following a traumatic shoulder dislocation is known to cause significant morbidity especially as ost-traumatic dislocations occur in young active patients. The management of this injury is still controversial. There is always a debate between those that recommend surgical stabilization following a 1st time dislocation (FTD) and those that prefer treating them conservatively. The aim of treatment following a dislocation is to manage the episode such that there is no threat of recurrence, there is a full functional recovery with no apprehension, and an ability to get back to the same level of sporting activity. Purpose: The purpose of the study is to review the current literature and provide recommendations regarding management following FTD. Design: Clinical overview, Perspective. Methods: Review of literature using PUBMED, MEDLINE. Results: The present thought process is towards Arthroscopic primary stabilization following 1st time post-traumatic dislocation in young active individuals with projected significant overhead activities. Conclusion: Management of a patient following a FTD/subluxation has been the subject of debate for a long time. A number of factors have been studied and published such as age, sports participation, sex, pathological findings after the dislocation to enable the surgeon to decide on the management of this condition. Recurrence comes at a cost of increasing the instability with every episode of dislocation. More the instability before the surgical stabilization, more are the chances of either failure or the requirement of a salvage procedure like a Latarjet with its inherent high complication rate. But not every patient with FTD should warrant a surgical stabilization. A personalized approach is recommended and not a one size fits all approach.