Comparing external vs. internal rotation immobilization following primary anterior shoulder dislocation: a meta-analysis.

Study Summary

17 studies including 1170 patients with first-time anterior shoulder dislocation were included in this systematic review and meta-analysis comparing external rotation (ER) versus internal rotation (IR) immobilization. Pooled outcomes included the Western Ontario Shoulder Instability Index (WOSI), Constant-Murley Score, return-to-sport rates, recurrent shoulder dislocation, and shoulder apprehension. IR immobilization demonstrated a statistically significant but clinically insignificant improvement in WOSI scores compared with ER immobilization. However, no significant differences were observed in shoulder function, return to sport, recurrent dislocation, or shoulder apprehension. Overall, both immobilization strategies produced comparable clinical outcomes, suggesting that routine ER bracing offered no meaningful advantage over conventional IR immobilization.