SHOULDER & ELBOW
Immobilization in external rotation after primary shoulder dislocation did not reduce the risk of recurrence: A randomized controlled trial.
This report has been verified
by one or more authors of the
original publication.
OrthoEvidence Journal (OE Journal) - ACE Report
OE Journal. 2013;1(4):40 J Bone Joint Surg Am. 2011 May 18;93(10):897-904. Epub 2011 Apr 15.Exclusive Author Interview
Dr. Liavaag discusses shoulder immobilization following primary shoulder dislocation.
188 patients with primary traumatic anterior shoulder dislocation were randomized to be managed by immobilization in either internal rotation or 15° of external rotation for a period of 3 weeks. The 2-year follow up concludes that the re-dislocation rates were similar in both the treatment groups.
Was the allocation sequence adequately generated?
Was allocation adequately concealed?
Blinding Treatment Providers: Was knowledge of the allocated interventions adequately prevented?
Blinding Outcome Assessors: Was knowledge of the allocated interventions adequately prevented?
Blinding Patients: Was knowledge of the allocated interventions adequately prevented?
Was loss to follow-up (missing outcome data) infrequent?
Are reports of the study free of suggestion of selective outcome reporting?
Were outcomes objective, patient-important and assessed in a manner to limit bias (ie. duplicate assessors, Independent assessors)?
Was the sample size sufficiently large to assure a balance of prognosis and sufficiently large number of outcome events?
Was investigator expertise/experience with both treatment and control techniques likely the same (ie.were criteria for surgeon participation/expertise provided)?
はい = 1
不確実＝0.5
無関係 = 0
いいえ = 0
報告基準評価では、著者が出版物内で試験の方法論的特徴や試験特性を報告する際の透明性を評価します。評価は以下の5つのカテゴリーに分類されます。
4/4
Randomização
3/4
Medidas de resultado
4/4
Inclusão/Exclusão
4/4
Descrição do tratamento
4/4
Estatística
Detsky AS, Naylor CD, O'Rourke K, McGeer AJ, L'Abbé KA. J Clin Epidemiol. 1992;45:255-65
Fragility Indexは、重要な所見の解釈を助けるツールで、結果の強さの尺度を提供します。Fragility Indexは、その所見が有意でなくなるために、二項対立の結果に追加する必要がある連続した事象の数を表します。数値が小さいほど弱い所見を表し、数値が大きいほど強い所見を表します。
なぜ今この研究が必要なのですか？
There is a high risk of recurrence following a primary traumatic anterior shoulder dislocation, especially in the younger population. There have been several variable suggestions as to the best management. The orthopedic community is divided over the usefulness of the immobilization in external rotation. The study provides much needed evidence to determine best management.
主な研究課題は何ですか？
Does immobilization in external rotation provides any additional benefit to the future risk of recurrence, compared to standard immobilization in internal rotation?
重要な知見は？
- recurrence rate of 30.8% with immobilization in external rotation vs. 27.1% in internal rotation
- mean time to recurrence 10.5 months in External rotation group vs. 11.6 months in Internal Rotation group.
- median WOSI Score of 238 in external rotation vs. 375 in internal rotation group
最も覚えておくべきことは？
External rotation immobilizers are not beneficial to reduce the risk of future shoulder dislocation.
それが私の患者ケアにどのように影響するか？
Although this study finds that external rotation immobilizers are not beneficial, the sample size may be too small for definitive conclusions.
免責事項
このページに記載されている内容は、情報提供のみを目的としたものであり、専門的な医療アドバイス、診断、治療の代わりとなるものではありません。治療が必要な場合は、必ず医師の診断を仰ぐか、最寄りの救急外来を受診してください。このページに記載されている内容に関して個人が表明した意見、信念、見解は、OrthoEvidenceの意見、信念、見解を反映するものではありません。
0の4 月間無料記事のロック解除
