First-time traumatic anterior dislocation of the shoulder in young adults: the position of the arm during immobilisation revisited.

In contrast to the surgical treatment of chronic shoulder instability, there are only scarce publications about the management after a first episode of anterior shoulder dislocation and how to prevent the evolution towards chronic instability. We present here a review of the literature on this subject. Particular attention is paid to recent studies about the position of the arm during immobilisation. According to recent views, it may be preferable to immobilise the arm in external rather than internal rotation, but this has to be confirmed by further clinical studies. The issue of early arthroscopic stabilisation after a first dislocation event in young athletic patients is also discussed.