Surgery Advised for First-Time Shoulder DislocationPeople under 30 years old who dislocate their shoulder for the first time have a 75 and 95 percent that the same shoulder will dislocate again. Researchers continue to study whether surgery is the best choice after a first-time shoulder dislocation.
There is still a chance of a second dislocation after surgery. Yet it is less likely than without surgery at all. Treatment without an operation consists of immobilization. The shoulder is held against the body with a sling for four weeks. Then, a program of exercises is prescribed and supervised by a physical therapist.
It takes about four months to get better without surgery. After this, the patient can return to work or sports. For those patients who are treated with surgery, the operation is done as soon as possible. This is usually within the first two weeks after the injury. After surgery, a rehabilitation program lasting four months is typical.
Doctors are trying to find out why some people dislocate the shoulder a second time. What are the risk factors for reinjury with or without surgery? It may be the level of activity a patient resumes after injury or surgery. People in the military have heavy physical demands placed on them. In the general population, some people are unwilling or unable to change the way they use their arm. These patients seem to be at greater risk for reinjury.
Surgery to repair a first-time shoulder dislocation can help restore the joint. This is the treatment advised for young, athletic adults (under 25 years of age). Any tissue that is torn is quickly repaired. This helps the joint get its normal function back. This approach shows less chance of a second dislocation.
Craig R. Bottoni, MD, et al. A Prospective, Randomized Evaluation of Arthroscopic Stabilization Versus Nonoperative Treatment in Patients with Acute, Traumatic, First-Time Shoulder Dislocations. In The American Journal of Sports Medicine. July/August 2002. Vol. 30. No. 4. Pp. 576-580.
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