Materiały źródłowe

• #1 Traumatic Sports Injuries of the Shoulder: Fractures, Separations, and Other Injuries | PM&R KnowledgeNow

  https://now.aapmr.org/shoulder-fractures-separation-dislocation-and-other-soft-tissue-injuries/

  In the United States, the incidence of shoulder dislocations is 23.9/100,000-person years and approximately 8598% of initial shoulder dislocations are anterior dislocations. Dislocated shoulders tend to occur more often in males than in females. 71.8% of shoulder dislocations are in males. This gender difference is likely due to association with contact sports. In men, the peak age is 20-30 years and it is 61-80 years in women. The later peak in women is attributed to increased falls in an aging population. […] The incidence of AC joint separation is between 9-12% of shoulder girdle injuries, with Type I or II making up the majority of that percentage. The majority are due to contact sports and occur in young males between 20 to 30 years of age.

• #2 Shoulder Dislocations: Reduction and Stabilization — USF Emergency Medicine

  https://www.tampaemergencymedicine.org/blog/shoulder-dislocations-reduction-and-stabilization

  The shoulder is the most commonly dislocated joint, making up nearly 50% of major joint dislocations. In the United States, the incidence of shoulder dislocations is approximately 23.9 per 100,000 person years. […] Shoulder dislocations tend to occur more often in young males (age 20-30 years) with male to female ratio of 9:1, and in older females (age 61-80 years) with female to male ratio of 3:1. […] There are a variety of treatment approaches including procedural sedation, intra-articular lidocaine, US-guided brachial plexus or interscalene block, and a plethora of reduction techniques. Generally, the reduction method depends on clinician preference and the patients condition. […] Although the vast majority of shoulder dislocations treated in the ED will be anterior, it is imperative to be aware of differences in managing posterior dislocations.

• #3 Epidemiology of shoulder dislocations presenting to emergency departments in the United States – PubMed

  https://pubmed.ncbi.nlm.nih.gov/20194311/

  The epidemiology of traumatic shoulder dislocations is poorly understood. The aim of the current study was to determine the incidence of shoulder dislocations presenting to hospital emergency departments in the United States and define demographic risk factors for these injuries. […] A total of 8940 shoulder dislocations were identified, resulting in an overall incidence rate in the United States of 23.9 (95% confidence interval, 20.8 to 27.0) per 100,000 person-years. The male incidence rate was 34.90 (95% confidence interval, 30.08 to 39.73) per 100,000 person-years, with an incidence rate ratio of 2.64 (95% confidence interval, 2.39 to 2.88) relative to the female incidence rate. It was found that 71.8% of the dislocations were in males. […] The estimated incidence rate of shoulder dislocations in the United States is 23.9 per 100,000 person-years, which is approximately twice the previously reported value. A young age and male sex are risk factors for shoulder dislocation in the United States population.

• #4 Incidence of shoulder dislocations in the UK, 1995–2015: a population-based cohort study | BMJ Open

  https://bmjopen.bmj.com/content/7/11/e016112

  Objective This cohort study evaluates the unknown age-specific and gender-specific incidence of primary shoulder dislocations in the UK. […] A cohort of 16763 patients with shoulder dislocation aged 1670 years during 19952015 were identified. […] The overall incidence rate in men was 40.4 per 100000 person-years (95%CI 40.4 to 40.4), and in women was 15.5 per 100000 person-years (95%CI 15.5 to 15.5). […] This is the first time the incidence of shoulder dislocations has been studied using primary care data from a national database, and the first time the results for the UK have been produced. […] While most primary dislocations occurred in young men, an unexpected finding was that the incidence increased in women aged over 50 years, but not in men. […] The incidence of primary anterior shoulder dislocations has not been examined using all patients in a national dataset. The incidence of shoulder dislocations in the UK remains unknown, and a large population-based UK study has not been previously undertaken.

• #5 Epidemiology of shoulder dislocations presenting to United States emergency departments: An updated ten-year study

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10514709/

  Glenohumeral dislocation is a common injury that may predispose patients to chronic pain and instability. However, there is a paucity of current data available regarding the epidemiological trends of this injury. […] To provide an updated, comparative assessment of the epidemiology of shoulder dislocations presenting to emergency departments in the United States. We also sought to analyze patient demographic risk factors and consumer products associated with dislocation events. […] In total, an estimated 773039 shoulder dislocations (CI: 640598-905481) presented to emergency rooms across the United States during the study period. The annual incidence rate was 23.96 per 100000 persons and the average patient age at the time of injury was 37.1 years. […] The national annual incidence rate of glenohumeral dislocations throughout the study period was approximately 23.92 per 100000 persons. Male adolescents sustained the highest proportion of dislocations, with a peak incidence in age group 15-20 years, predominantly secondary to participation in sporting and recreational activities. Conversely, women experienced a relatively consistent incidence of dislocation throughout their lifespan. After age 63, the incidence rate of dislocations in females was found to surpass that observed in males.

• #6 Epidemiology of shoulder dislocations presenting to United States emergency departments: An updated ten-year study

  https://www.wjgnet.com/2218-5836/full/v14/i9/690.htm

  Epidemiology of shoulder dislocations presenting to United States emergency departments: An updated ten-year study. […] To provide an updated, comparative assessment of the epidemiology of shoulder dislocations presenting to emergency departments in the United States. […] In total, an estimated 773039 shoulder dislocations (CI: 640598-905481) presented to emergency rooms across the United States during the study period. […] The annual incidence rate was 23.96 per 100000 persons and the average patient age at the time of injury was 37.1 years. […] Significantly more male patients sustained dislocations than female patients (537189, 69.5%, vs 235834, 30.5%, P 0.001). […] The national annual incidence rate of glenohumeral dislocations throughout the study period was approximately 23.92 per 100000 persons.

• #7

  https://journals.lww.com/jbjsjournal/fulltext/2010/03000/epidemiology_of_shoulder_dislocations_presenting.3.aspx

  The epidemiology of traumatic shoulder dislocations is poorly understood. The aim of the current study was to determine the incidence of shoulder dislocations presenting to hospital emergency departments in the United States and define demographic risk factors for these injuries. […] A total of 8940 shoulder dislocations were identified, resulting in an overall incidence rate in the United States of 23.9 (95% confidence interval, 20.8 to 27.0) per 100,000 person-years. […] The estimated incidence rate of shoulder dislocations in the United States is 23.9 per 100,000 person-years, which is approximately twice the previously reported value. A young age and male sex are risk factors for shoulder dislocation in the United States population.

• #8 Shoulder Dislocation Incidence and Risk Factors—Rural vs. Urban Populations of Poland

  https://www.mdpi.com/1660-4601/19/19/11857

  Shoulder dislocation is a trauma that nearly all emergency department doctors confront at some point during their professional careers due to its high incidence. In Poland, the incidence of shoulder dislocation is 26.69/100,000 person-years. […] The incidence rate was 25.97/100,000 person-years in rural areas and 25.62/100,000 person-years in urban areas. […] No significant difference in the incidence rate of shoulder dislocation between Polish residents living in rural and urban areas emerged. […] The highest incidence was observed among female subjects 80+ years old living in urban environments. The highest risk was found among men in the third decade of their life living in urban areas. […] Epidemiological studies are missing on shoulder dislocations based on metadata analyses describing or comparing entire populations or their significant subgroups beyond risk groups.

• #9 Shoulder Dislocation: Practice Essentials, Epidemiology, Functional Anatomy

  https://emedicine.medscape.com/article/93323-overview

  An epidemiologic study by Becker et al showed that most shoulder dislocations occurred in men (72.1%). More than half (52.5%) of shoulder dislocations were related to sports participation, and the majority of the dislocations were associated with basketball (16.4%), American football (15.6%), and cycling (9.0%).

• #9 Shoulder Dislocation: Practice Essentials, Epidemiology, Functional Anatomy

  https://emedicine.medscape.com/article/93323-overview

  The shoulder is the most commonly dislocated joint in the body. […] Patients with a previous shoulder dislocation are more prone to redislocation. This occurs because the tissue does not heal properly and/or because the tissue stretches out and becomes more lax. […] Other factors that show a clear correlation to redislocation are the age of the patient and concomitant rotator cuff tears and fractures of the glenoid. […] Younger patients (teenagers and those aged 20 years) have a much higher frequency of redislocation than patients in their 50s and 60s. […] In a retrospective cohort study, Kardouni et al found the 10-year incidence rate of shoulder dislocations in US Army soldiers to be 3.13 per 1000 person-years, or a total of 15,426 incident shoulder dislocations. The recurrence rate was 28.7%.

• #10 Anterior shoulder dislocation | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/anterior-shoulder-dislocation?lang=us

  Broadly speaking, anterior shoulder dislocations occur in a bimodal age distribution. The first, and by far the more prevalent age group are young adult men who have sustained high-energy injuries to the shoulder. The second group is older patients who have been injured with a much lower level of violence. In older patients, the dislocation usually proves to be an isolated event. […] flattened, shallow anterior/anteroinferior glenoid bony contour: may predispose to recurrent dislocations.

• #11 Shoulder Dislocation in Emergency Medicine: Background, Etiology, Epidemiology

  https://emedicine.medscape.com/article/823843-overview

  In the United States, the incidence of shoulder dislocations is 23.9 per 100,000 person years, and approximately 85-98% of shoulder dislocations are anterior dislocations. Dislocated shoulders tend to occur more often in males than in females. In males, the peak age of incidence is 20-30 years (with a male-to-female ratio of 9:1), and in females it is 61-80 years (with a female-to-male ratio of 3:1). The incidence of proximal humerus fractures increases with age, with a population-adjusted incidence of 101 per 100,000 person years in those older than 65 years. […] Shoulder dislocation occurs more frequently in adolescents than in younger children because the weaker epiphyseal growth plates in children tend to fracture before dislocation occurs. In older adults, collagen fibers have fewer cross-links, making the joint capsule and supporting tendons and ligaments weaker and dislocation more likely. Anterior dislocation is most commonly seen in those aged 18-25 years resulting from sporting injury. The second most common age group to sustain anterior dislocation is the elderly, because of their susceptibility to falls.

• #12

  https://step2.medbullets.com/orthopedics/120534/anterior-shoulder-dislocation

  Epidemiology […] Incidence […] one of the most common serious shoulder injuries […] 95% of shoulder dislocations are anterior […] 2-4% of shoulder dislocations are posterior […] 1% of shoulder dislocations are inferior […] shoulder dislocations constitute approximately half of all joint dislocations […] Demographics […] bimodal gender distribution […] common in young males (20-30 years of age) with male-to-female ratio of 9:1 […] common in older females (60-80 years of age) with female-to-male ratio of 3:1

• #13 Epidemiology of shoulder dislocations presenting to United States emergency departments: An updated ten-year study

  https://www.wjgnet.com/2218-5836/full/v14/i9/690.htm

  Male adolescents sustained the highest proportion of dislocations, with a peak incidence in age group 15-20 years, predominantly secondary to participation in sporting and recreational activities. […] Conversely, women experienced a relatively consistent incidence of dislocation throughout their lifespan. […] After age 63, the incidence rate of dislocations in females was found to surpass that observed in males. […] The national annual incidence of shoulder dislocations in the United States was approximately 23.92 per 100000 persons, with a predominance of dislocations occurring in male adolescents between the ages of 15-20. […] There is a bimodal distribution of shoulder dislocations in the United States. […] A large portion of male adolescents sustain these injuries between the ages of 15-20 secondary to participation in sporting events. […] Conversely, women have a relatively consistent incidence of dislocations in their lifespan with an increase in their later decades of life.

• #14 Anterior instability: Epidemiology, history, physical examination, imaging, and nonoperative treatment | Musculoskeletal Key

  https://musculoskeletalkey.com/anterior-instability-epidemiology-history-physical-examination-imaging-and-nonoperative-treatment/

  Approximately 1% to 2% of the population will experience a glenohumeral dislocation in their lifetime. Anterior glenohumeral dislocations account for almost 85% of all shoulder dislocations and has been reported as high as 89% to 98%. A population-based cohort study from the United Kingdom following 17,000 patients over 20 years (1995 to 2015) found that approximately 72% of shoulder dislocations occurred in men, and the highest incidence (80.5 per 100,000 person-years) was found in young males, aged 16 to 20 years. For females, the highest incidence occurred in women aged 61 to 70 years old. Similarly, a 2010 study from the United States showed an overall incidence of 23.9 per 100,000 person-years, with the incidence in males 2.6 times higher than in females. It is believed the true incidence could be even greater because many dislocations may spontaneously reduce and not present to an emergency department. In all, only 20% of anterior shoulder dislocations occur in individuals older than 60 years. Contact athletes are at an especially higher risk for shoulder dislocation. American football athletes have shown shoulder dislocation incidence up to 0.51 per 1000 athlete-exposures, and the prevalence of shoulder dislocation during one season of rugby has been shown to be approximately 15%. Thus anterior shoulder instability occurs most commonly in young, active males who participate in contact sports.

• #15

  https://www.orthobullets.com/shoulder-and-elbow/3051/posterior-shoulder-instability-and-dislocation

  Posterior shoulder instability and dislocations are less common than anterior shoulder instability and dislocations, but are much more commonly missed. […] Incidence: 2% to 5% of all unstable shoulders. […] 50% of traumatic posterior dislocations seen in the emergency department are undiagnosed.

• #16 Posterosuperior shoulder dislocation due to the rupture of deltoid posterior fibers: a case report | BMC Musculoskeletal Disorders | Full Text

  https://bmcmusculoskeletdisord.biomedcentral.com/articles/10.1186/s12891-019-2727-5

  Superior shoulder dislocation is a rare type of shoulder dislocation. Its occurrence is thought to be associated with rupture of the deltoid; however, few reports are available on the mechanism of onset and the treatment of a superior shoulder dislocation. […] This is the first case of posterosuperior shoulder dislocation. It suggests that rupture of the deltoid posterior fibers contributes to the onset of posterosuperior shoulder dislocation in patients with a massive rotator cuff tear. Moreover, in superior shoulder dislocation, conservative treatment may result in continuing instability which requires surgical treatment. […] Previous reports state that superior shoulder dislocation occurs together with deltoid rupture and massive rotator cuff tears. […] The present case highlights two clinical issues. First, our case suggests that posterior deltoid rupture contributes to the onset of posterosuperior shoulder dislocation in patients with massive rotator cuff tears.

• #17

  https://journals.lww.com/jbjsjournal/fulltext/2011/09070/the_epidemiology,_risk_of_recurrence,_and.6.aspx

  Posterior glenohumeral dislocation is less common than anterior dislocation, and less is known about its epidemiology, functional outcome, and complications. […] The prevalence of posterior dislocation was 1.1 per 100,000 population per year, with peaks in male patients between twenty and forty-nine years old, and in the elderly patients over seventy years old. […] The prevalence of posterior dislocation is low. The most common complication after this injury is recurrent instability, which occurs at an early stage in 17.7% of shoulders within the first year after dislocation. The risk is highest in patients who are less than forty years old, sustain the dislocation during a seizure, and have a large humeral head defect. The risk is lower for most patients who sustain the injury from a traumatic accident, especially if they are older and have a small anterior humeral head defect. There are persistent deficits of shoulder function within the first two years after the injury.

• #18 Risk Factors Associated with First Time and Recurrent Shoulder Instability: A Systematic Review | Published in International Journal of Sports Physical Therapy

  https://ijspt.scholasticahq.com/article/116278-risk-factors-associated-with-first-time-and-recurrent-shoulder-instability-a-systematic-review

  Shoulder instabilities constitute a large proportion of shoulder injuries and have a wide range of presentations. […] While evidence regarding glenohumeral dislocations and associated risk factors has been reported, less is known regarding the full spectrum of instabilities and their risk factors. […] The purpose of this systematic review was to identify modifiable risk factors to guide patient management decisions with regards to implementation of interventions to prevent or reduce the risk of shoulder instability. […] Male sex, participation in sport, hypermobility in males, and glenoid index demonstrated moderate to large risk associated with first time shoulder instability. […] Male sex, age 30 years, and history of glenohumeral instability with concomitant injury demonstrated moderate to large risk associated with recurrent shoulder instability.

• #19 Risk Factors Associated with First Time and Recurrent Shoulder Instability: A Systematic Review | Published in International Journal of Sports Physical Therapy

  https://ijspt.scholasticahq.com/article/116278-risk-factors-associated-with-first-time-and-recurrent-shoulder-instability-a-systematic-review

  There may be an opportunity for patient education in particular populations as to their increased risk for suffering shoulder instability, particularly in young males who appear to be at increased risk for recurrent shoulder instability. […] The incidence of glenohumeral dislocations has been reported as high as 23.9 (95% CI: 20.8 to 27.0) per 100,000 person-years and a lifetime prevalence between 2-8% in the general population in the United States. […] Risk factors for acute (mostly anterior) dislocation have been identified and include age, sex, sport participation, immobilization protocol, and glenoid shape. […] Despite the frequency of GH shoulder instability, many unknowns remain regarding risk factors. […] The results of this study shed light on several key risk factors associated with both first-time and recurrent shoulder instability.

• #20 Shoulder dislocation and instability | Healthengine Blog

  https://healthinfo.healthengine.com.au/shoulder-dislocation-and-instability-2

  Around 2% of the population have some instability of the shoulder joint. Overall, 1.7% of people dislocate their shoulder, though this statistic may almost double in people with high physical demands. Almost half of dislocations occur in people aged between 15 and 29. […] Risk factors for shoulder dislocation include: Gender: Around 70% of shoulder dislocations occur in males; Age: Almost half of dislocations occur between the ages of 15 and 29; Mechanism: 95% of anterior shoulder dislocations are due to traumatic injury, most commonly resulting from a fall (60%). Almost half of dislocations occur during sports or recreation. Those who play certain sports, or who undertake activities with high physical demands (such as individuals in the armed forces) are at increased risk; Location: 47.7% of dislocations occur at home, while 34.5% occur at sites of sports or recreation; Anatomy and function: It is likely that factors such as shallow joint sockets, weak shoulder muscles, and loose ligaments increase the risk of shoulder dislocation, although these factors have not been proven in studies; and Previous dislocation: The strongest risk factor for shoulder dislocation is previous dislocation.

• #21 Management of primary anterior shoulder dislocations: a narrative review | Sports Medicine – Open | Full Text

  https://sportsmedicine-open.springeropen.com/articles/10.1186/s40798-019-0203-2

  The recurrence rate following acute anterior shoulder dislocations is high, particularly in young, active individuals. […] Nearly half (48.6%) of all shoulder dislocations occur in patients 15 to 29 years old, with the highest rate of recurrent dislocations (64%) found in those under age 30 and a male-to-female incidence rate ratio of 2.64. […] Recurrent shoulder instability following a traumatic dislocation usually develops within the first 2 years of primary dislocation. […] The purpose of this study, then, is to comprehensively consolidate existing literature and provide a guide for optimal evidence-based management of traumatic anterior shoulder dislocations. […] For patients under 30, non-surgical treatment has been associated with significantly higher rates of recurrent dislocation outside of young adolescents.

• #22 Shoulder Dislocation: Symptoms, and Treatment | Doctor

  https://patient.info/doctor/shoulder-dislocation

  How common is shoulder dislocation? (Epidemiology)5 […] The incidence of glenohumeral joint is as high as 24 per 100,000 persons annually. […] This dislocation results from contact sports, falls, bicycle accidents, and similar high-impact trauma. […] A combined force of abduction, extension, and external rotation on the shoulder causes an anterior shoulder dislocation, which constitutes about 90% of dislocations. […] Posterior dislocations can also occur from a posteriorly directed force on a flexed shoulder, or from an electric shock or seizure injury. […] Inferior (luxatio erecta) and superior dislocations are less common.

• #23 Epidemiology of Shoulder Dislocations Presenting to Emergency Departments in the United States, 2007–2020 in: International Journal of Athletic Therapy and Training Volume 29 Issue 3 (2024)

  https://journals.humankinetics.com/abstract/journals/ijatt/29/3/article-p149.xml

  Shoulder dislocations are the most commonly treated joint dislocation in the emergency department. […] The purpose of our study was to provide an updated epidemiological report from 2007 to 2020. […] A total of 26,203 shoulder dislocations were recorded in the National Electronic Injury Surveillance System database from 2007 to 2020. […] The highest rates occurred in males (71.4%, n=18,722) and patients aged 20-29 years old (28.2%, n=7,292). […] The most common mechanism of injury was sports involvement (48.6%, n=12,735). […] Our findings suggest that rates of shoulder dislocations have remained consistent with previous research on this topic, indicating no significant changes over the past 19 years. […] More effective prevention strategies are needed, especially for at-risk populations. […] Adolescent males are at the highest risk for shoulder dislocation. […] Sporting activities are the most common reported mechanism for patients with shoulder dislocations who present to the emergency department. […] Incidence rates of shoulder dislocations have not changed in the last 20 years.

• #24 Shoulder Dislocation in Emergency Medicine: Background, Etiology, Epidemiology

  https://emedicine.medscape.com/article/823843-overview

  In an epidemiologic study of patients treated in emergency departments, Becker et al demonstrated that the majority of shoulder dislocations occurred in men (72.1%). More than half (52.5%) of shoulder dislocations were associated with sports activities, and most dislocations were related to participation in basketball (16.4%), American football (15.6%), or cycling (9.0%). […] In a study of shoulder dislocation data from the High School Reporting Information Online (RIO) and the National Collegiate Athletic Association (NCAA) Injury Surveillance Program (ISP) databases, high school athletes were found to have an overall shoulder dislocation rate of 2.04 per 100,000 athletic exposures, and college athletes had an overall injury rate of 2.58 per 100,000 athletic exposures. […] A subsequent examination of data on shoulder dislocation from the High School RIO and NCAA ISP databases showed an overall incidence rate of 38.19 per 100,000 persons at risk among high school and college athletes.

• #25 Shoulder Dislocation

  https://mobile.fpnotebook.com/Ortho/Shoulder/ShldrDslctn.htm

  Incidence: 24 per 100,000 persons per year. […] Most commonly dislocated joint (50% of all major joint dislocations). […] Seizure is responsible for approximately one third of cases (remainder due to Trauma). […] Diagnosis has been delayed weeks to months in some cases with significant complications. […] Risk of neurovascular injury and complicated Humeral Fractures with non-reduced bone fragments. […] Consider CT Angiogram. […] Imaging Indications: Age over 40 years or other risks for pathologic Fracture. […] First-time Shoulder Dislocation. […] Traumatic mechanism suggests risk for more significant injury (suspected Fracture). […] Unclear diagnosis.

• #26

  https://link.springer.com/article/10.1007/s00402-022-04420-6

  Epileptic seizures can cause multiple shoulder injuries, the most common of which are dislocations, recurrent instability, fractures, and isolated lesions of the rotator cuff. […] The average age at the time of injury of 106 included patients was 39.717.5 years and a male predominance was recorded (65%). […] A younger age, bilateral shoulder injuries and shoulder dislocations were significantly associated with the occurrence of a shoulder injury solely by muscular activation (p=0.0054, p=0.011, p=0.0001). […] The complication rate in 57 surgically treated patients with follow-up data was 38.7%, with recurring instability being the most frequently reported complication (62.5%). […] Uncontrolled muscle activation during a seizure is a distinctive but not exclusive dynamic of injury in epileptic patients, accounting for more than the half of all shoulder lesions, especially in the younger.

• #27 First-time anterior shoulder dislocation natural history and epidemiology: immobilization versus early surgical repair – Gurney-Dunlop – Annals of Joint

  https://aoj.amegroups.org/article/view/3919/4563

  Traumatic anterior shoulder dislocations are a common problem. Anterior shoulder dislocations have an estimated general population prevalence of 2% to 8% and overall incidence rate in the United States of 23.9 per 100,000 person-years. The incidence of recurrent instability ranges from 14% to 100% in the literature. Young males, who are at a high risk of having a first-time dislocation, are known to be at an increased risk of recurrent instability. Hovelius et al. reported a recurrence rate of 72% among patients aged 12-22 years, 56% of those 23-29 years and 27% in patients older than 30 years. Contact or overhead sports were found to be associated with a higher risk for recurrence compared to non-contact or no sport participation. Significant bone defects of the glenoid, humeral head or both are known risk factors for recurrent instability. Generalized ligamentous laxity has been shown as a risk factor for primary traumatic anterior shoulder dislocation and subsequent recurrences. Patients older than 40 years old at the time of their initial traumatic anterior shoulder dislocation require special consideration as they can present with pathology likely not seen in younger individuals. Following primary traumatic anterior shoulder dislocation, there is a high likelihood of recurrent instability with age, gender, level and type of sport, soft-tissue and bony factors each playing a role.

• #28 Management of primary anterior shoulder dislocations: a narrative review | Sports Medicine – Open | Full Text

  https://sportsmedicine-open.springeropen.com/articles/10.1186/s40798-019-0203-2

  One study, over 10 years, determined that conservatively managed patients exhibited a 62% recurrence rate compared with 9% in surgically repaired patients. […] Re-dislocation of the glenohumeral joint is very common even after appropriate treatment, with some studies reporting recurrence rates exceeding 70%. […] A study of 15,246 anterior shoulder dislocations found an overall recurrence of 28.7%. […] Another study of 154 anterior shoulder dislocations found a similar trend, with a 68% recurrence rate in patients under 20 years old, 54% in patients under 30, and only 12% in patients over 30. […] The commonality of recurrent anterior shoulder dislocations can be attributed to the shoulder anatomy deformities present following initial dislocation. […] An evaluation of 714 athletes found a glenoid bone loss of 6.8% after a first-time anterior shoulder instability event and a total calculated glenoid bone loss of 22.8% in the setting of recurrent instability.

• #29 Anterior instability: Epidemiology, history, physical examination, imaging, and nonoperative treatment | Musculoskeletal Key

  https://musculoskeletalkey.com/anterior-instability-epidemiology-history-physical-examination-imaging-and-nonoperative-treatment/

  Numerous factors contribute to the likelihood of recurrent anterior instability of the shoulder, with younger age the most significant risk factor. Male sex and activity level with those involved in contact sports are also at higher risk. All of these variables should be taken into account and weighed in the formulation of the treatment plan. […] The age of the patient at the time of the initial dislocation has a major influence on the incidence of recurrent instability. Several authors have reported that patients younger than 20 years at the time of the initial dislocation have up to a 90% chance of recurrent instability. In patients older than 40 years, the incidence drops sharply to 10% to 15%. […] The incidence of recurrent instability is lower when a first-time shoulder dislocation is associated with a greater tuberosity fracture. This may be due to a variety of factors: increased trauma and hemorrhage from the fracture may lead to greater stimulation to repair and form scar tissue, and these fractures also tend to occur in older patients.

• #30 Shoulder Injuries – Gymnastics Medicine

  https://gymnasticsmedicine.org/shoulder/

  Shoulder dislocations can occur at any age, but before the age of 20 you have an 80-90% chance of dislocating again without treatment. […] Gymnasts who have a shoulder dislocation before the age of 20 have an 80-90% chance of dislocating again and thus if a dislocation occurs they should seek medical attention and treatment.

• #31 Shoulder Dislocation – Harvard Health

  https://www.health.harvard.edu/staying-healthy/shoulder-dislocation-a-to-z

  Shoulder dislocations are the most common joint dislocation seen by emergency room doctors, accounting for more than 50% of all dislocations treated in hospitals. Young adult men and older women tend to be the groups with the highest rate of shoulder dislocations. […] For example, if you are a teenage athlete and you play contact sports such as football or hockey, after a shoulder dislocation your overall risk of a second shoulder dislocation may be as high as 90%. Repeat injury may make your shoulder unstable enough that it needs to be repaired with surgery. Surgery usually restores the shoulder’s stability and reduces the risk of future dislocation to 5% or less. […] If you are an adult and have an uncomplicated shoulder dislocation, your risk of a second dislocation is low, with repeat dislocations occurring only about 25% of the time for people in their 30s and even less often for older age groups.

• #32 First-time anterior shoulder dislocation natural history and epidemiology: immobilization versus early surgical repair – Gurney-Dunlop – Annals of Joint

  https://aoj.amegroups.org/article/view/3919/html

  Traumatic anterior shoulder dislocations are a common problem. Anterior shoulder dislocations have an estimated general population prevalence of 2% to 8% and overall incidence rate in the United States of 23.9 per 100,000 person-years. The incidence of recurrent instability ranges from 14% to 100% in the literature. Young males, who are at a high risk of having a first-time dislocation, are known to be at an increased risk of recurrent instability. Hovelius et al. reported a recurrence rate of 72% among patients aged 12-22 years, 56% of those 23-29 years and 27% in patients older than 30 years. Contact or overhead sports were found to be associated with a higher risk for recurrence compared to non-contact or no sport participation. Significant bone defects of the glenoid, humeral head or both are known risk factors for recurrent instability. Generalized ligamentous laxity has been shown as a risk factor for primary traumatic anterior shoulder dislocation and subsequent recurrences. Patients older than 40 years old at the time of their initial traumatic anterior shoulder dislocation require special consideration as they can present with pathology likely not seen in younger individuals. Hovelius and Saeboe looked at the presence of arthropathy after a primary anterior traumatic dislocation 25 years later. Following primary traumatic anterior shoulder dislocation, there is a high likelihood of recurrent instability with age, gender, level and type of sport, soft-tissue and bony factors each playing a role.

• #33 Shoulder Dislocation in Emergency Medicine: Background, Etiology, Epidemiology

  https://emedicine.medscape.com/article/823843-overview

  A Greek study examined the demographic data and recurrence rates of shoulder dislocations of 308 patients (170 men and 138 women) and found that the most frequent mechanism of injury was falling, and 92% of reductions were in the ED. The overall recurrence rate in all age groups was 50% but rose to almost 89% in the 14- to 20-year-old age group. […] A German study showed that the incidence of shoulder dislocations among professional football players is 9.1 per 1000 matches played.

• #34 Management of primary anterior shoulder dislocations: a narrative review | Sports Medicine – Open | Full Text

  https://sportsmedicine-open.springeropen.com/articles/10.1186/s40798-019-0203-2

  A primary study evaluating recurrent dislocations in cases of glenoid bone loss found recurrence rates similar to the rest of the literature, with a 27% rate in patients over 30 and a 72% rate in patients under 23 years old. […] In addition, more recent studies, including a systematic review and meta-analysis, found that younger patient age, male sex, glenohumeral joint hyperlaxity, higher activity levels, increased pain, and higher levels of reinjury fear also increase the risk of dislocation recurrence.

• #35 Anterior shoulder dislocation – assessment and treatment | Tidsskrift for Den norske legeforening

  https://tidsskriftet.no/en/2021/08/klinisk-oversikt/anterior-shoulder-dislocation-assessment-and-treatment

  Anterior shoulder dislocation can occur in connection with a traumatic event or as a result of an anatomical predisposition. A study by Liavaag et al. estimated the incidence of anterior shoulder dislocations in Oslo to be approximately 26/100 000 person-years. The rate is three times higher in men, and among those under the age of 20, the incidence is 98/100 000 person-years. […] According to a recent meta-analysis, as many as seven out of ten people may experience multiple instability episodes after dislocating their shoulder. The risk of recurrent dislocations depends on several factors, including the mechanism of injury, the extent of damage to the bony and soft tissue structures, and patient-specific factors such as gender, age and activity level. […] A bony injury in connection with anterior shoulder dislocation increases the risk of recurrent instability episodes and a reduced function level. Glenoid bone loss of 15-20 % is considered to be a critical limit, because it increases the risk of repeated instability episodes and impaired shoulder function. […] The risk of non-recurrence-related complications following arthroscopy after first-time shoulder dislocation is 1.6 %. This includes subcutaneous suture abscesses, transient paraesthesia, and frozen shoulder.

• #36 Shoulder Dislocation/Instability | Pediatric Orthopaedic Society of North America (POSNA)

  https://posna.org/physician-education/study-guide/shoulder-dislocation-instability

  Traumatic dislocations are rare in children under 10 years old, accounting for less than 2% of dislocations. But, 20% of shoulder dislocations occur in patients under 20 years old. […] Most literature focuses on treatment of adolescent/skeletally mature shoulder dislocations due to their high recurrence rates. […] Current evidence favors nonsurgical treatment for primary dislocations in skeletally immature patients given lower recurrence rates than adolescent and adult patients. […] Axillary nerve injuries are reported in 42% of traumatic anterior shoulder dislocations.

• #37 Epidemiology of Paediatric Shoulder Dislocation: A Nationwide Study in Italy from 2001 to 2014

  https://ideas.repec.org/a/gam/jijerp/v17y2020i8p2834-d348065.html

  Limited knowledge is accessible concerning the tendencies of hospitalization for skeletally immature patients with episodes of shoulder dislocation. […] Our research aim was to evaluate annual hospitalizations for shoulder dislocation in paediatric patients in Italy from 2001 to 2014, on the basis of the official data source as hospitalization reports. […] The last aim was to make statistical predictions of the number of shoulder dislocation hospitalization volumes and rates in skeletally immature patients based on data from 2001 to 2014. […] In the 14-year study time, 344 hospitalizations for shoulder dislocation of patients aged 0-14 years took place in Italy. […] The mean incidence of hospitalizations in Italy for shoulder dislocation in patients with less than 14 years was 0.3 for every 100,000 inhabitants in the same class of age.

• #38 Diagnosis and treatment of posterior shoulder instability based on the ABC classification in: EFORT Open Reviews Volume 9 Issue 5 (2024)

  https://eor.bioscientifica.com/view/journals/eor/9/5/EOR-24-0025.xml

  In a young and active military population, PSI has been identified in 10% of all shoulder instability cases, and more than half were affected with recurrent PSI presumably not due to a single, acute traumatic injury but as an accumulative result of repetitive microtraumatic load during military activities such as push-ups, combatives, and weightlifting, which might indicate a higher occurrence of PSI than previously described in the literature. […] Type C1 has been observed in a case series of young patients who did not experience any history of trauma, inflammatory disease, or posterior glenoid erosion preceding the static PSI at presentation. Its epidemiological occurrence and risk factors are still poorly understood and need further investigation. […] Type C2 can be observed among young children (1 years), affecting approximately 7% of all brachial plexus birth lesions. […] The clinical presentation of group C may vary from asymptomatic during early stages, pain during shoulder-demanding activities, instability symptoms, or joint stiffness to permanent pain when posterior cartilage damage and osteoarthritis progress.

• #39

  https://link.springer.com/article/10.1007/s00402-022-04420-6

  This can lead both to anterior and posterior dislocations or fracture-dislocations and is frequently cause of bilateral lesions and of instability recurrence after surgery. […] The high complication rates after surgical treatment in this selected subgroup of patients require that appropriate preventative measures are taken to increase the probability of treatment success. […] This study analysed the epidemiology, dynamics of injury, specific lesion characteristics and treatment results of a large cohort of patients suffering seizure-related shoulder injuries, confirming the extremely high frequency of bilateral injuries and posterior shoulder dislocations in this selected group of patients as compared to the general population. […] Shoulder injury treatment in epilepsy patients is burdened by a high complication rate, especially after patients undergo surgery for instability; a recurring instability developed in almost two-thirds of those patients who underwent operative treatment.

• #40

  https://austinpublishinggroup.com/emergency-medicine/fulltext/aem-v1-id1002.php

  The prevalence of nerve injury after anterior shoulder dislocation increases with age. […] Extreme care is also necessary when dealing with chronically dislocated shoulders in the elderly (defined as more than 3 weeks) due to risk of axillary artery rupture. […] In summary, recurrent shoulder dislocations are not uncommon in the elderly, and manipulation and reduction in the AE department should proceed with care due to the increased risk of complications, with a low threshold for conscious reduction under general anesthesia if the initial attempt is unsuccessful.

• #40

  https://austinpublishinggroup.com/emergency-medicine/fulltext/aem-v1-id1002.php

  Shoulder dislocation is the most common large joint dislocation seen in the Accident and Emergency (AE) Department with an incidence of 8.2-24 per 100,000 person-years, of which 96% are anterior shoulder dislocations. […] Its occurrence in the elderly population is less common and as the elderly usually has multiple medical comorbidities including osteoporosis, treatment with manipulation and reduction of a shoulder dislocation in the elderly has to be attempted with extreme care due to associated complications. […] The prevalence of recurrent shoulder dislocation is around 50-75% for adolescents and young adults (up to 25 years of age) whereas various studies on patients over 60 years old have quoted prevalence up to 22% in elderly patients. […] Up to 83% of elderly patients with a shoulder dislocation have a tear of the rotator cuff, and it is important to evaluate symptomatic elderly patients with imaging 2-4 weeks after reduction as earlier rotator cuff repairs may yield better results.

• #41 Shoulder dislocation and instability | Healthengine Blog

  https://healthinfo.healthengine.com.au/shoulder-dislocation-and-instability

  Around 2% of the population have some instability of the shoulder joint. Overall, 1.7% of people dislocate their shoulder, though this statistic may almost double in people with high physical demands. Almost half of dislocations occur in people aged between 15 and 29. […] The average age of individuals who dislocate their shoulder for the first time occurs in two peaks. The first group tends to be young adult men, with injury occurring due to high-impact mechanisms. The smaller second group are older individuals with lower-impact mechanisms of injury and lower rates of re-dislocation. Dislocation may result in further instability of the shoulder joint, which may present as subtle joint looseness, or recurrent dislocation. Up to a third of people who experience shoulder dislocation go on to develop long-term shoulder arthritis.

• #42 Shoulder dislocation and instability | Healthengine Blog

  https://healthinfo.healthengine.com.au/shoulder-dislocation-and-instability

  The consequences of traumatic anterior shoulder dislocation depend on the severity of injury and the age of the person when they first dislocate their shoulder. The younger the person at first dislocation, the more likely they are to dislocate again. In athletic people aged younger than 20 years, rates of recurrent dislocation are as high as 90%, decreasing to 50-75% in people aged 20-25 years. In people older than 40 years, anterior shoulder dislocation is associated with lower rates of instability, but higher rates of rotator cuff muscle tears (15%). The risk of rotator cuff tears increases to 40% in people older than 60 years. The recurrence rate of dislocation is also related to the degree of injury of structures that support the shoulder joint at the time of dislocation.

• #43 Risk Factors Associated with First Time and Recurrent Shoulder Instability: A Systematic Review | Published in International Journal of Sports Physical Therapy

  https://ijspt.scholasticahq.com/article/116278-risk-factors-associated-with-first-time-and-recurrent-shoulder-instability-a-systematic-review

  Overall, understanding these risk factors can inform targeted strategies for prevention and management of shoulder instability, potentially improving patient outcomes and guiding clinical decision-making. […] The results of this systematic review suggest there may be a number of predictive variables for first time dislocation or recurrent dislocations.

• #44 Epidemiology of Shoulder Dislocation among National Collegiate Associate Athletes – TIMEPortal

  https://timeportal.uchicago.edu/UME/ScholarlyOpportunities/Projects/141

  The shoulder is the most commonly dislocated joint in the body. This injury often results from direct contact with another player, the playing surface, or equipment. A shoulder dislocation can also occur by an indirect mechanism in which the athlete falls on an elbow or outstretched hand. The incidence of shoulder dislocation (primary and recurrent) in the United States has been estimated to be between 23.9 and 26.9 per 100,000 person-years. A population-based epidemiological study is needed to understand the injury prevalence, mechanisms of injury, and recovery patterns in NCAA student-athletes. We expect the study to find a higher rate of shoulder dislocation among high contact sports such as football, ice hockey, and wrestling. […] This study will aid clinicians when discussing with athletes their risk for shoulder dislocation and their risk for potential recurrence.

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