Cochrane · systematic review · CD004962
Conservative management following closed reduction of traumatic anterior dislocation of the shoulder
Braun, C, McRobert, CJ · Cochrane Database of Systematic Reviews · 2019 · Cochrane Library
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
7
current version
GRADE rated
5
No studies
2
Included studies
NR
No studies 2 · 28.6%Ungraded 0 · 0%Very low 5 · 71.4%Low 0 · 0%Moderate 0 · 0%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Current version onlyImmobilisation in external rotation versus immobilisation in internal rotation following closed reduction of traumatic anterior dislocation of the shoulder
Population: patients undergoing conservative management after closed reduction of traumatic anterior dislocation of the shoulder
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Re‐dislocation Immobilisation in external rotation vs immobilisation | RR 0.67 [0.38, 1.19] | 6 studies · 488 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, publication bias |
Validated patient‐reported outcome measures for shoulder disabilityf Immobilisation in external rotation vs immobilisation | no estimate extracted | 4 studies · 380 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, publication bias |
Resumption of pre‐injury activities Immobilisation in external rotation vs immobilisation | no estimate extracted | 3 studies · 347 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, publication bias |
Participant satisfaction with the intervention Immobilisation in external rotation vs immobilisation | no estimate extracted | NR | No studies |
Quality of life Immobilisation in external rotation vs immobilisation | no estimate extracted | NR | No studies |
Any instability: re‐dislocation or subluxation, composite outcome Immobilisation in external rotation vs immobilisation | RR 0.84 [0.62, 1.14] | 3 studies · 395 participants | Very low Downgraded: risk of bias, imprecision, publication bias |
Adverse events Immobilisation in external rotation vs immobilisation | no estimate extracted | 7 studies · 645 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Immobilisation in external rotation compared with immobilisation in internal rotation for traumatic anterior dislocation of the shoulder
Population: patients with traumatic anterior dislocation of the shoulder
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Re‐dislocation, with two‐year or longer Immobilisation in external rotation vs immobilisation | RR 1.06 [0.73, 1.54] | 3 studies · 252 participants | Very low Downgraded: risk of bias, inconsistency |
Validated participant‐reported outcome measures for shoulder instability Western Ontario Shoulder Instability Index (WOSI). Scale from 0 to 2100 Immobilisation in external rotation vs immobilisation | no estimate extracted | 1 study · 174 participants | Ungraded |
Resumption of sport at any level, with two‐year or longer Immobilisation in external rotation vs immobilisation | RR 1.13 [0.87, 1.48] | 1 study · 109 participants | Very low Downgraded: risk of bias |
Resumption of sport/activities, with two‐year or longer Immobilisation in external rotation vs immobilisation | RR 1.25 [0.71, 2.2] | 2 studies · 278 participants | Very low Downgraded: risk of bias |
Participant satisfaction with the intervention—not reported Immobilisation in external rotation vs immobilisation | no estimate extracted | NR | No studies |
Any instability (subluxation or re‐dislocation), with two‐year or longer Immobilisation in external rotation vs immobilisation | RR 0.82 [0.5, 1.33] | 2 studies · 322 participants | Very low Downgraded: risk of bias, inconsistency |
Important adverse events Mechanism of data collection unclear Immobilisation in external rotation vs immobilisation | RR 0.61 [0.08, 4.46] | 2 studies · 216 participants | Very low Downgraded: risk of bias |