Immobilisation in external rotation after first-time traumatic anterior shoulder instability reduces recurrent instability: a meta-analysis

ImportanceCadaveric and MRI findings have demonstrated significantly less labral separation displacement when the shoulder is placed in external rotation as compared with internal rotation.ObjectiveThe purpose of current study to meta-analyse randomised controlled trials literature compare immobilisation versus after first-time anterior dislocation.Evidence reviewA search MEDLINE, EMBASE Cochrane Library was performed based on Preferred Reporting Items for Systematic Reviews Meta-Analyses guidelines. Randomised comparing dislocation were included.FindingsNine 795 patients included. The mean age included 29 years, 82.4% male follow-up 25.5 months. As rotation, compliance higher (74.5% vs 67.4%, p=0.01), rate recurrent dislocations lower (22.2% 33.4%, p=0.02) rotation. Additionally, 20–40 years old those treated than (12.1% 31.4%, p=0.006). Immobilisation also resulted a return preinjury level play (60.1% 42.6%, p=0.0001).Conclusions relevanceImmobilisation traumatic results rate, rotation.Level evidenceLevel I. Cadaveric dislocation. A Nine p=0.0001).