Limits...
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.

Show MeSH

Related in: MedlinePlus

The waist strap.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

f6-wjem-16-114: The waist strap.

Mentions: The waist strap from the shoulder immobilizer (Figure 6) is then fitted around the patient’s waist and fastened. The arm strap is placed around the patient’s arm, while the slightly shorter wrist strap (Figure 7) is placed around the patient’s wrist; both are fastened. The fasteners of these straps then adhere to the foam exterior of the external rotation bump, thus supporting the arm. The free stockinette ends of the external rotation bump are then tied around the patient’s neck. The external rotation bump can be further molded, to an ideal shoulder position of 10 degrees of external rotation, and 20 degrees of abduction (Figure 8).


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)

The waist strap.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

f6-wjem-16-114: The waist strap.
Mentions: The waist strap from the shoulder immobilizer (Figure 6) is then fitted around the patient’s waist and fastened. The arm strap is placed around the patient’s arm, while the slightly shorter wrist strap (Figure 7) is placed around the patient’s wrist; both are fastened. The fasteners of these straps then adhere to the foam exterior of the external rotation bump, thus supporting the arm. The free stockinette ends of the external rotation bump are then tied around the patient’s neck. The external rotation bump can be further molded, to an ideal shoulder position of 10 degrees of external rotation, and 20 degrees of abduction (Figure 8).

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