Prediction of fracture associated with anterior shoulder dislocation.
- Report By: Steffen Genthe, MD - Emergency Medicine Resident II
- Search checked by Steffen Genthe, MD - Emergency Medicine Resident II
- Institution: Michigan State University GRMERC Emergency Medicine Residency
- Date Submitted: 12th May 2005
- Last Modified: 17th May 2005
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Status:
Blue (submitted but not checked)
Three Part Question
In [emergency department patients with anterior shoulder dislocation] which [historical factors predict] [shoulder fracture]?Clinical Scenario
Your are an emergency medicine resident in a busy downtown tertiary care facility. Your 14th patient of the night is a 23-year-old male with a clinically obvious anterior shoulder dislocation. The dislocation was spontaneous and is his third this year. As a matter of routine a pre-reduction x-ray is ordered. ED beds are scarce and the the nurse asks if this is really necessary. Is it?Search Strategy
Medline 1966-03/05 using the OVID interface, Cochrane Library (2005)[(exp shoulder dislocation/ or anterior shoulder dislocation.mp) AND (*shoulder fractures/di, ra, ep). LIMIT to human AND English.
Search Outcome
37 papers found of which 36 were irrelevant or of insufficient quality.Relevant Paper(s)
| Author, date and country | Patient group | Study type (level of evidence) | Outcomes | Key results | Study Weaknesses |
|---|
Clinical Bottom Line
In selected patients, x-rays may be unnecessary in the management of anterior shoulder dislocation.References
- Emond M. Le Sage N. Lavoie A. Rochette L. Clinical factors predicting fractures associated with an anterior shoulder dislocation. Academic Emergency Medicine. 11(8):853-8, 2004 Aug.