Abstract
AN AUDIT ON THE MANAGEMENT OF THE FIRST TIME SHOULDER DISLOCATION AFTER REDUCTION

Ashraf Omor, MD*. Amal El-Husban, MD. Nizar Al-Brayhie, MD. Suhaib Werikat, MD.
And Alhawawsheh Mohammad, MD

ABSTRACT

Background: Acute shoulder dislocation carries a high risk of shoulder instability, Rotator cuff injury, and reduction in functional outcome. And their management after reduction has a crucial role in determining long-term morbidity. This paper aims To audit the management of first-time shoulder dislocation against the British Elbow & Shoulder Society (BESS) Guidelines. These guidelines are described as the following; All patients under 25 years should have early specialist risk assessment and shared decision making by shoulder surgeon before 6 weeks, patients between 25-40 years should be reassessed at the 3-6 month mark and diagnostic specialist imaging should be obtained if still symptomatic, and patients over 40 years should have early diagnostic imaging and early rotator cuff repair. Methods: A retrospective audit was carried out at King Hussein Medical Center identifying 50 patients presenting with acute shoulder dislocation over a 6 months period. After reduction, management plan and follow-up notes were analyzed and compared to the British Elbow & Shoulder Society (BESS) Guidelines. Results and conclusion: Low Adherence to BESS guidelines in managing such injuries were observed, especially for the young and the above 40-year-old age groups. Through departmental education and the introduction of clear protocols, the treatment of such injuries can be optimized.

Keywords: Shoulder, dislocation, audit.


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