Effectiveness of external-rotation immobilization after initial shoulder dislocation in reducing recurrence rates.

CLINICAL SCENARIO Initial, traumatic shoulder dislocations, particularly in an anterior direction, are among the most common shoulder injuries. Traditionally, nonsurgical treatment for first-time shoulder dislocations consists of immobilization in internal rotation (IR). However, there is a high rate of recurrence after this course of treatment. Recent reports indicate that immobilization in external rotation (ER) instead of IR may more effectively reduce recurrence rates, resulting in a viable nonsurgical treatment option for patients sustaining an initial shoulder dislocation.