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Low-cost alternative external rotation shoulder brace and review of treatment in acute shoulder dislocations.

Lacy K, Cooke C, Cooke P, Schupbach J, Vaidya R - West J Emerg Med (2015)

Bottom Line: Immediate closed reduction of both anterior and posterior glenohumeral dislocations is recommended and is frequently performed in the ED.Recurrence of dislocation is common, as anteroinferior labral tears (Bankart lesions) are present in many anterior shoulder dislocations.14,15,18,23 Immobilization of the shoulder following closed reduction is therefore recommended; previous studies support the use of immobilization with the shoulder in a position of external rotation, for both anterior and posterior shoulder dislocations.7-11,19 In this study, we present a technique for assembling a low-cost external rotation shoulder brace using materials found in most hospitals: cotton roll, stockinette, and shoulder immobilizers.The low-cost external rotation shoulder brace is therefore a more affordable option for the uninsured patient presenting with acute shoulder dislocation.

View Article: PubMed Central - PubMed

Affiliation: Detroit Medical Center, Department of Orthopaedic Surgery, Detroit, Michigan.

ABSTRACT
Traumatic dislocations of the shoulder commonly present to emergency departments (EDs). Immediate closed reduction of both anterior and posterior glenohumeral dislocations is recommended and is frequently performed in the ED. Recurrence of dislocation is common, as anteroinferior labral tears (Bankart lesions) are present in many anterior shoulder dislocations.14,15,18,23 Immobilization of the shoulder following closed reduction is therefore recommended; previous studies support the use of immobilization with the shoulder in a position of external rotation, for both anterior and posterior shoulder dislocations.7-11,19 In this study, we present a technique for assembling a low-cost external rotation shoulder brace using materials found in most hospitals: cotton roll, stockinette, and shoulder immobilizers. This brace is particularly suited for the uninsured patient, who lacks the financial resources to pay for a pre-fabricated brace out of pocket. We also performed a cost analysis for our low-cost external rotation shoulder brace, and a cost comparison with pre-fabricated brand name braces. At our institution, the total materials cost for our brace was $19.15. The cost of a pre-fabricated shoulder brace at our institution is $150 with markup, which is reimbursed on average at $50.40 according to our hospital billing data. The low-cost external rotation shoulder brace is therefore a more affordable option for the uninsured patient presenting with acute shoulder dislocation.

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Related in: MedlinePlus

Two 14-inch cotton rolls and 4 feet of 4 inch stockinette are prepared.
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f2-wjem-16-114: Two 14-inch cotton rolls and 4 feet of 4 inch stockinette are prepared.

Mentions: The low-cost external rotation shoulder brace consists of four components: the waist strap, the arm strap, the wrist strap, and the external rotation bump (Figure 1, Video). Materials for the external rotation shoulder brace include: two 14” practical cotton rolls, four feet of 4” stockinette roll (Figure 2), two standard shoulder immobilizer sets. To make the external rotation bump, the two 14” cotton rolls are rolled together into one thicker roll. The 4” stockinette is then rolled in on itself in a cuff-like fashion, leaving roughly two feet free of the cuff (Figure 3). An end of the cotton roll is then stuffed into the cuffed opening of the stockinette, for a snug fit. The stockinette cuff is then rolled over the cotton roll, engulfing it entirely (Figure 4). A waist strap from the first shoulder immobilizer set is then cut to size, wrapped around the cotton-stuffed stockinette, and fastened. This serves as the external rotation bump (Figure 5). The cotton within the bump can be molded with compression over the posterior aspect, so as to create the desired degree of external rotation.


Low-cost alternative external rotation shoulder brace and review of treatment in acute shoulder dislocations.

Lacy K, Cooke C, Cooke P, Schupbach J, Vaidya R - West J Emerg Med (2015)

Two 14-inch cotton rolls and 4 feet of 4 inch stockinette are prepared.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4307694&req=5

f2-wjem-16-114: Two 14-inch cotton rolls and 4 feet of 4 inch stockinette are prepared.
Mentions: The low-cost external rotation shoulder brace consists of four components: the waist strap, the arm strap, the wrist strap, and the external rotation bump (Figure 1, Video). Materials for the external rotation shoulder brace include: two 14” practical cotton rolls, four feet of 4” stockinette roll (Figure 2), two standard shoulder immobilizer sets. To make the external rotation bump, the two 14” cotton rolls are rolled together into one thicker roll. The 4” stockinette is then rolled in on itself in a cuff-like fashion, leaving roughly two feet free of the cuff (Figure 3). An end of the cotton roll is then stuffed into the cuffed opening of the stockinette, for a snug fit. The stockinette cuff is then rolled over the cotton roll, engulfing it entirely (Figure 4). A waist strap from the first shoulder immobilizer set is then cut to size, wrapped around the cotton-stuffed stockinette, and fastened. This serves as the external rotation bump (Figure 5). The cotton within the bump can be molded with compression over the posterior aspect, so as to create the desired degree of external rotation.

Bottom Line: Immediate closed reduction of both anterior and posterior glenohumeral dislocations is recommended and is frequently performed in the ED.Recurrence of dislocation is common, as anteroinferior labral tears (Bankart lesions) are present in many anterior shoulder dislocations.14,15,18,23 Immobilization of the shoulder following closed reduction is therefore recommended; previous studies support the use of immobilization with the shoulder in a position of external rotation, for both anterior and posterior shoulder dislocations.7-11,19 In this study, we present a technique for assembling a low-cost external rotation shoulder brace using materials found in most hospitals: cotton roll, stockinette, and shoulder immobilizers.The low-cost external rotation shoulder brace is therefore a more affordable option for the uninsured patient presenting with acute shoulder dislocation.

View Article: PubMed Central - PubMed

Affiliation: Detroit Medical Center, Department of Orthopaedic Surgery, Detroit, Michigan.

ABSTRACT
Traumatic dislocations of the shoulder commonly present to emergency departments (EDs). Immediate closed reduction of both anterior and posterior glenohumeral dislocations is recommended and is frequently performed in the ED. Recurrence of dislocation is common, as anteroinferior labral tears (Bankart lesions) are present in many anterior shoulder dislocations.14,15,18,23 Immobilization of the shoulder following closed reduction is therefore recommended; previous studies support the use of immobilization with the shoulder in a position of external rotation, for both anterior and posterior shoulder dislocations.7-11,19 In this study, we present a technique for assembling a low-cost external rotation shoulder brace using materials found in most hospitals: cotton roll, stockinette, and shoulder immobilizers. This brace is particularly suited for the uninsured patient, who lacks the financial resources to pay for a pre-fabricated brace out of pocket. We also performed a cost analysis for our low-cost external rotation shoulder brace, and a cost comparison with pre-fabricated brand name braces. At our institution, the total materials cost for our brace was $19.15. The cost of a pre-fabricated shoulder brace at our institution is $150 with markup, which is reimbursed on average at $50.40 according to our hospital billing data. The low-cost external rotation shoulder brace is therefore a more affordable option for the uninsured patient presenting with acute shoulder dislocation.

Show MeSH
Related in: MedlinePlus