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> > Is anyone routinely immobilising 1st (new) shoulder > dislocations in external rotation and have the results been audited? > > > These two papers show the evidence for immobilising new > anterior shoulder dislocations in external rotation in the > younger age group < 40 yrs. > > There are new splints on the market... though they cost about > £50 in the UK The first of these two studies was effectively an interim report. The entire study was intended to include 80 patients in each arm. The second interim report has also been presented- this did not show as much difference between the groups. I don't know whether the final report has been published yet. Itoi (and some Australians as well) has also published cadaver studies. Certainly looks like it works in areas with high compliance (as Ray suggests, compliance in the UK isn't all that great; and the external rotation splint is more limiting than a broad arm sling). If it had 100% effectiveness it would obviate the need for Bankhart repairs. However, the fact that in the second interim report there was an appreciable recurrence in the intervention group. This has implications for cost effectiveness- should we be proceeding to MRI and primary surgical repair for Bankharts? Like many people, it seems, we're currently at the stage of thinking that this is interesting and ought to work. Our orthopods are interested (we are fortunate enough to have all our shoulder dislocations going to one of our orthopods with a subspecialist interest in shoulders), but nobody has been able to find the funding for this yet. > May the strong winds > always blow behind you, Where's this one from, Danny? In my experience, a strong wind from dead behind you risks a broach to or an accidental jibe, and doesn't usually move you forwards as fast as one from abaft the beam. I'm (pretty) sure this isn't what you meant. Although if you're referring to Rowley's being lead clinician, it seems a rather good metaphor. Matt Dunn Warwick This email has been scanned for viruses by NAI AVD however we are unable to accept responsibility for any damage caused by the contents. The opinions expressed in this email represent the views of the sender, not South Warwickshire General Hospitals NHS Trust unless explicitly stated. If you have received this email in error please notify the sender. The information contained in this email may be subject to public disclosure under the NHS Code of Openness or the Freedom of Information Act 2000. Unless the information is legally exempt from disclosure, the confidentiality of this e-mail and your reply cannot be guaranteed.