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Treatment Offers Hope To Patients with Dislocated Shoulders

Armen Hareyan's picture

Dislocated Shoulders Treatment

A better, non-surgical treatment for dislocated shoulders could hinge on how patients' arms are immobilized during the healing process, say University of Colorado sports medicine researchers who are heading up a national study.

The CU Sports Medicine Center at University of Colorado Hospital hopes to determine whether a new sling that positions the arm at an outward angle rather than across the abdomen will help younger, active people heal better and faster from shoulder dislocations. Researchers believe the new sling could help patients avoid invasive surgeries and keep them from re-injuring their shoulders.

Research shows that the shoulder is the most dislocated joint in the body, and most who suffer such injuries are younger, athletic people in the most active years of their lives. In addition, people who dislocate a shoulder are prone to repeat injuries. As such, innovative, non-surgical therapies that do not require long rehabilitations are sought after.

"We want to see if we can improve non-operative treatment options," said Eric McCarty, M.D., an associate professor at the CU School of Medicine and chief of sports medicine and shoulder surgery in the department of orthopedics. "This would help keep health care costs down and reduce risks to patients."

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Aided by a grant from the Orthopedic Research and Education Foundation (OREF), researchers at CU and other campuses hope to recruit study participants under the age of 30 as part of efforts to build on a Japanese study that involved older patients.

The traditional, non-surgical treatment for dislocated shoulders involves immobilizing the arm across the abdomen or in an internal rotation, followed by two to six weeks of physical therapy. During the study led by CU researchers, participants' arms will be immobilized at an outward angle or external rotation, followed by physical therapy.

When a shoulder is dislocated, the labrum, a capsule surrounding the joint in which ligaments develop tension, separates from the bone, and surgery puts it back in place. External immobilization might bring the torn labrum closer to its pre-injury location, and researchers hope to determine if this position will allow the labrum to heal better, reducing the likelihood of re-injury. Researchers will take magnetic resonance imaging (MRI) scans to monitor healing and track recurrence rates among patients participating in the study.

The anterior dislocation is the most common type of shoulder injury, occurring in about 90 percent of all shoulder dislocations. In this type of injury, the ball or top of the humerus bone slips out of the front of the joint. Less common is the posterior dislocation, when the ball comes out of the back of the joint. Most often, shoulder dislocations occur when active people get their arm caught out to the side during an athletic activity such as ice skating or hockey.

Traditional treatment for dislocated shoulders tends to be conservative for a first-time injury, with a patient's arm often immobilized in a sling for two to six weeks, followed by physical therapy. However, because younger patients remain at higher lifetime risk for a repeat injury, surgery is more commonly performed on them as a more aggressive way to repair the tear and prevent additional dislocations, McCarty said.

University of Colorado Hospital is the Rocky Mountain region's leading academic tertiary care and referral center.