Comparative Effectiveness of Different Immobilization Techniques in Managing Reduction of Acute Anterior Shoulder Dislocation: A Retrospective Cohort Study
Bibliographic record
Abstract
Abstract Purpose The treatment of primary traumatic anterior shoulder dislocation varies widely. However, recent basic science and clinical data do not unify the specific immobilization methods. We aimed to compare the effectiveness of immobilization in internal rotation, external rotation and external rotation combined abduction after primary anterior dislocation of the shoulder. Methods A total of 165 patients (80 males and 85 females, average age, 61 years, range 18–73 years) with the diagnosis of acute primary traumatic anterior shoulder dislocation were immobilized at in internal rotation (IR, n = 62), external rotation (ER, n = 53), external rotation combined abduction (ERAb, n = 50) after manipulative reduction. The mean follow-up period was 23.85 months (range 16–28 months). Patients received rehabilitation program immediately after immobilization. We assessed functionality by constant-Murley score (CMS), American Shoulder and Elbow Surgeons Scale (ASES) and stability by Western Ontario Shoulder Instability Index (WOSI) in week 6, months 3, 6, 12, and 24 . Otherwise, the measured humeral upward distance (HUD) and humeral forward distance (HFD) on Computed Tomography (CT) of the shoulder were determined in day 1 and sixth weeks after immobilization. Results for HUD and HFD, there were statistically significant differences between shoulder joint immobilization at 1 day and 6 weeks within each group ( P < 0.001), and there were all significantly bigger than in the contralateral side on the day 1 of immobilization ( P < 0.001), but after 6 weeks of shoulder joint immobilization, although slight differences existed between the affected and non-affected side in each group, none of these varieties reached significance ( P > 0.05). Intragroup comparisons of the constant-Murley score (CMS), American Shoulder and Elbow Surgeons Scale (ASES) and Western Ontario Shoulder Instability Index (WOSI) in the different time periods revealed significant differences ( P < 0.001). Furthermore, upon release of immobilization at the 6-week postoperative interval, the ERAb group demonstrated superior early phase mobility and functional recovery compared to the other two cohorts. However, longitudinal evaluation revealed no statistically significant differences in functional outcomes among the groups after the 3-month follow-up assessment. Conclusions Internal rotation, external rotation, and external rotation combined abduction immobilization are effective methods for reducing postoperative complications of acute anterior shoulder dislocation and we recommend the external rotation combined abduction immobilization approach to promote early recovery of shoulder function.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".