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Archives of Orthopaedic and Trauma Surgery

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Open Access 01-04-2015 | Orthopaedic Surgery

Survey on the management of acute first-time anterior shoulder dislocation amongst Dutch public hospitals

Authors: T. D. Berendes, P. Pilot, J. Nagels, A. J. H. Vochteloo, R. G. H. H. Nelissen

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 4/2015

Abstract

Introduction

The primary aim of this study was to record how orthopaedic surgeons are currently managing acute first-time anterior shoulder dislocation (AFASD) 8 years after introduction of the Dutch national guideline: “acute primary shoulder dislocation, diagnostics and treatment” in 2005. The second aim was to evaluate how these surgeons treat recurrent instability after AFASD.

Materials and methods

An online questionnaire regarding the management of AFASD and recurrent shoulder instability was held amongst orthopaedic surgeons of all 98 Dutch hospitals.

Results

The overall response rate was 60 %. Of the respondents, 75 % had a local protocol for managing AFASD, of which 28 % had made changes in their treatment protocol after the introduction of the national guideline. The current survey showed wide variety in the overall treatment policies for AFASD. Twenty-seven percent of the orthopaedic surgeons were currently unaware of the national guideline. The variability in treatment for AFASD was present throughout the whole treatment from which policy at the emergency department; when to operate for recurrent instability; type of surgical technique for stabilization and type of fixation of the labrum. As for the treatment of recurrent instability, the same variability was seen: 36 % of the surgeons perform only arthroscopic procedures, 7 % only open and 57 % perform both open and arthroscopic procedures.

Conclusions

Despite the introduction of the national guideline for the initial management of AFASD in 2005, still great variety among orthopaedic surgeons in the Netherlands was present. As for the surgical stabilization technique, the vast majority of the respondents are performing an arthroscopic shoulder stabilization procedure at the expense of the more traditional open procedure as a first treatment option for post-traumatic shoulder instability.

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Title: Survey on the management of acute first-time anterior shoulder dislocation amongst Dutch public hospitals
Authors: T. D. Berendes
P. Pilot
J. Nagels
A. J. H. Vochteloo
R. G. H. H. Nelissen
Publication date: 01-04-2015
Publisher: Springer Berlin Heidelberg
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 4/2015
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-015-2156-3

At a glance: The STEP trials

Springer Medicine

Survey on the management of acute first-time anterior shoulder dislocation amongst Dutch public hospitals

Abstract

Introduction

Materials and methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Introduction

Materials and methods

Results

Conclusions

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