No Difference in Pain and Activities of Daily Living Between Immobilization in External and Internal Rotation Following Acute Anterior Shoulder Dislocation: Results of a Randomized Controlled Trial

Background The conventional treatment for anterior shoulder dislocations is immobilising the arm in adduction and internal rotation. However, recent basic science and clinical data indicate that immobilization in external rotation can reduce recurrent instability. The use of external rotation brace is not widespread, due to compliance and convenience issues. The purpose of our study is to compare pain and restriction in day-to-day activities experienced by patients after being immobilized in the two types of braces (external rotation and internal rotation) at the end of one week. Methods Between February 2023 to July 2024, 50 patients with acute shoulder dislocation (primary or recurrent) were randomized (concealed, computer-generated) to immobilization with either an internal rotation brace (n=26) or an external rotation brace (n=24). Validated scores (Pain-visual analog scale (VAS) for pain, Katz Index for independence in activities of daily living) were used to collect data on the day of Immobilization and at the end of one week of immobilization. Results There was no statistically significant difference (P>0.05) in Pain-VAS and Katz Index scores among the two brace types (external rotation and internal rotation) at the end of one week of follow-up. There was no loss in follow-up in either of our study groups. Conclusion Immobilization in external rotation after reduction of acute shoulder dislocation did not significantly differ from immobilization in internal rotation in terms of pain and limitations in activities of daily living experienced by the patient in the first week of immobilization.