Authors: Mohammed Alshalhoub , Hamad Alawlah , Mohammed Alageel , Lina Alhumaid , Dana Altamimi , Mohammed Benmeakel

Abstract

Background: Shoulder dislocations are common occurrences, with anterior shoulder dislocations being the most prevalent. Various reduction techniques are employed, but success rates and influencing factors remain variable. This study aims to evaluate the success rate of anterior shoulder reductions performed by emergency physicians, as well as factors contributing to reduction failure and extended emergency department (ED) stay. Methods: A retrospective cross-sectional study was conducted at King Abdulaziz Medical City from 2019 to 2022, focusing on patients presenting with closed anterior shoulder dislocation. Data were collected from medical records included patient demographics, mechanism of injury, method of reduction, and length of stay in the ED. Statistical analyses explored associations and relationships between variables. Results: A total of 179 patients were included. The mean age was 32 years. Most patients had normal BMI (34.6%), and the right shoulder was more frequently affected (56.4%). Falls (38.0%) and daily activities (33.5%) were common mechanisms of injury. Patients presenting within 3 hours had a mean ED stay of 3 hours and 54 minutes, compared to 6 hours and 43 minutes for those presenting later (p < 0.001). The success rate was 94.8% for early presenters and 84.3% for late presenters. Orthopedic involvement resulted in longer ED stays (8 hours and 48 minutes ± 5 hours and 20 minutes), while those without orthopedic referral had shorter stays (4 hours and 40 minutes ± 3 hours and 17 minutes). The waiting time for outpatient appointments was significantly shorter for patients with orthopedic involvement (8 days) compared to those without (39 days, p < 0.001). Conclusion: Emergency medicine physicians achieved a high success rate in reducing anterior shoulder dislocations. The study underscores the importance of early presentation to the ED and orthopedic involvement in achieving favorable outcomes. The findings contribute to enhancing the understanding and management of closed anterior shoulder dislocations in emergency medicine.

Keywords: Anterior shoulder dislocation, Emergency medicine physicians, Orthopedic involvement