Summary of findings for immobilisation in external versus internal rotation after a first-time traumatic shoulder dislocation
| Immobilisation in external rotation compared with internal rotation for prevention of recurrent dislocations or chronic instability after a first-time traumatic shoulder dislocation | ||||||
| Patient or population: a first-time traumatic shoulder dislocation in general population Setting: non-surgical versus non-surgical management Intervention: immobilisation in external rotation Comparison: immobilisation in internal rotation | ||||||
| Outcome Number of participants (studies) | Relative effect (95% CI) | Anticipated absolute effects (95% CI) | Certainty | What happens | ||
| IR | ER | Difference | ||||
| Recurrent instability rate after immobilisation in treatment of primary shoulder dislocation in older population Follow-up: mean 2 years Number of participants: 261 (two RCTs) | RR 0.31 (0.06 to 1.68) | 38.4% | 11.9% (2.3 to 64.5) | 26.5% fewer (36.1 fewer to 26.1 more) | ⨁◯◯◯ Very low* | Immobilisation in external rotation does not seem to be beneficial in prevention of shoulder instability. |
| Redislocation rate after immobilisation in treatment of primary shoulder dislocation in younger population Follow-up: mean 2 years Number of participants: 287 (three RCTs) | RR 1.07 (0.76 to 1.50) | 30.3% | 32.4% (23.0 to 45.4) | 2.1% more (7.3 fewer to 15.1 more) | ⨁⨁◯◯ Low† | Immobilisation in external rotation does not seem to be beneficial in prevention of shoulder redislocations. |
*Rated down for serious risk of bias (lack of blinding), serious inconsistency and strongly suspected publication bias.
†Rated down for serious risk of bias (lack of blinding) and strongly suspected publication bias.
ER, external rotation; IR, internal rotation; RCT, randomised controlled trial; RR, relative risk.
Explanations for the Cochrane Summary of Findings table (http://www.cochranelibrary.com/about/explanations-for-cochrane-summary-of-findings-sof-tables.html)