Shoulder Dislocation: Who Is At Risk?Shoulder dislocations: how often do they occur and who is affected most often? Those are the two pieces of information sought in this study. And to find out just who is experiencing shoulder dislocations in the United States, a special collection of data from 100 hospital-based emergency departments was analyzed.
Almost 9,000 patient cases were recorded over a four-year period. The majority of these shoulder dislocations occurred as a result of a sudden fall. Two age groups were represented: between 20 and 29 and between 80 and 89. The younger group were more likely to fall during a sports or recreational activity. They were either athletes or military personnel (and sometimes military participating in sports). Football and basketball accounted for the majority of dislocations. Falls at home were more likely to be reported by the older adults.
In the younger group, men were represented two and a half times more often than women. The type of fracture and whether it was the first dislocation or a recurrence (second) dislocation were not recorded at most hospitals. Anyone with additional shoulder injuries sustained at the time of the shoulder dislocation (e.g., fractures, sprains, tears, contusions) was not included in this study.
The authors also took a look at whether or not shoulder dislocations occurred more or less often by race. Though more whites had a reported dislocation, analyzing the data and carrying out statistical calculations showed that no individual race (white, black, Hispanic, Native American, Asian) had more cases of shoulder dislocation than the others.
By now you may be wondering what difference does it make how old people are when they dislocate their shoulder? How can knowing what they were doing when they fell, or whether they are black, white, male, female, or other make a difference?
The intended goal of collecting this information is to try and prevent these injuries from happening. There has been a significant increase in the number of shoulder dislocations in this country over the past 20 years. And it is believed that the data collected doesn't tell the whole story. Many people manage to put the shoulder joint back in place and don't report it at all. Others see their primary care physician or go to an orthopedic surgeon (perhaps someone who has treated them in the past for other things or even for a previous shoulder dislocation). Cases like that don't get reported through the hospital emergency department data base.
There must be a reason for the rise in shoulder dislocations. Studies like this might be able to pinpoint what some of those risk factors may be. If possible, once those risk factors are identified, a prevention program might help. Decreasing the incidence of shoulder dislocations would reduce pain, suffering, cost, loss of income and productivity, as well as keep our athletes on the field and our soldiers on duty.
Taking a sample of shoulder dislocations from across the country doesn't include everyone but it does give us a peek inside the window. This kind of data can help identify trends of risk and maybe help us develop future prevention strategies. For now it looks like the group to start with are active young men and older adults. Strategies that work best to prevent shoulder dislocations may be the next step in this discovery process.
Michael A. Zacchilli, MD, and Brett D. Owens, MD. Epidemiology of Shoulder Dislocations Presenting to Emergency Departments in the United States. In The Journal of Bone and Joint Surgery. March 2010. Vol. 92-A. No. 3. Pp. 542-549.
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