Clinical and Functional Outcomes of Different Immobilization Strategies following Reduction of Primary Anterior Shoulder Dislocation: A Prospective Comparative Study

ABSTRACT Background: Optimal immobilization after primary anterior shoulder dislocation remains uncertain. This study compared internal-rotation sling immobilization with external-rotation bracing after successful closed reduction. Methods: Thirty patients aged 18–45 years with first-time traumatic anterior shoulder dislocation were prospectively studied, with 15 patients in each immobilization group. Functional outcome, pain, range of motion, recurrent instability, compliance, and return to activity were assessed over six months. Results: Mean six-month Rowe scores were 80.3±9.0 in the internal-rotation group and 75.3±13.4 in the external-rotation group (p=0.241). ASES scores were also similar. Recurrent instability occurred in 1/15 (6.7%) and 3/15 (20.0%) patients, respectively (p=0.598). External-rotation bracing resulted in greater external-rotation range of motion at six months (73.8° vs 64.6°, p=0.016), but brace intolerance was more frequent. All patients returned to work by six months. Conclusion: Both strategies produced substantial functional recovery. External-rotation bracing improved rotational mobility but did not demonstrate a clear advantage in overall function or recurrent instability. Keywords: Anterior shoulder dislocation; Immobilization; External rotation; Recurrent instability; Functional outcome