Epidemiology of glenohumeral dislocation and subsequent instability in an urban population

Shields, D. W., Jefferies, J. G., Brooksbank, A. J., Millar, N. and Jenkins, P. J. (2018) Epidemiology of glenohumeral dislocation and subsequent instability in an urban population. Journal of Shoulder and Elbow Surgery, 27(2), pp. 189-195. (doi:10.1016/j.jse.2017.09.006) (PMID:29133074)

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Abstract

Background: Glenohumeral dislocation is the most commonly encountered adult joint instability. The epidemiology in the United Kingdom and worldwide is unclear and often limited to young, active groups that are not representative of general populations. Information regarding epidemiology and outcome from a first dislocation is useful for trauma service planning and patient counseling. We calculated the incidence of shoulder instability after a first dislocation in our urban population and investigated predictors of recurrent instability. Methods: A prospectively collected trauma database was retrospectively examined to identify patients with a first-time dislocation. Demographics, subsequent dislocation, and instability details were collected from electronic patient records. Results: In a 38-month study period, 329 first dislocations occurred in a population of 475,147 with mean follow-up 28.5 months (range, 10-50 months). The overall incidence for first-time dislocations in this population was 21.9 per 100,000 population, of which 7.9% sustained a redislocation and 6.1% had further symptomatic instability. There were 18.8% with associated greater tuberosity fractures, 8.8% sustained a nerve injury, and 2.7% were posterior dislocations. A bimodal distribution was observed for males (peak incidence per 100,000 of 42.1 and 50.9 in 15-24 and ≥85 age groups, respectively), and unimodal for females (peak 45.7 in the 65-74 age group). Conclusion: We demonstrate a previously unreported burden of dislocation in older age groups and suggest a rate of recurrence lower than previously reported in the United Kingdom. The group aged 15 to 19 years was at the highest risk of recurrent dislocation and instability. Gender was not a significant predictor of instability.

Item Type:Articles
Keywords:Epidemiology, glenohumeral dislocation, instability, outcome, service planning, urban population.
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Jenkins, Mr Paul and Shields, Mr David and Millar, Dr Neal
Authors: Shields, D. W., Jefferies, J. G., Brooksbank, A. J., Millar, N., and Jenkins, P. J.
College/School:College of Medical Veterinary and Life Sciences > Institute of Infection Immunity and Inflammation
College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
Journal Name:Journal of Shoulder and Elbow Surgery
Publisher:Elsevier
ISSN:1058-2746
ISSN (Online):1532-6500
Published Online:10 November 2017
Copyright Holders:Copyright © 2017 Crown Copyright
First Published:First published in Journal of Shoulder and Elbow Surgery 27(2): 189-195
Publisher Policy:Reproduced in accordance with the copyright policy of the publisher.

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