Mansoor Maham, Datta Sunandan, Bandyopadhyay Bratati, Madhu Rachala, Raza Muhammad Tahir, Hussain Mohammed Wahaaj, Al-Jaafar Mustafa
Trauma and Orthopaedics, Aneurin Bevan University Health Board, Newport, GBR.
Trauma and Orthopaedics, The Grange University Hospital, Cwmbran, GBR.
Cureus. 2025 Jul 3;17(7):e87256. doi: 10.7759/cureus.87256. eCollection 2025 Jul.
Shoulder dislocation is the most common major joint dislocation encountered in our emergency department, with anterior dislocation accounting for the vast majority. This retrospective audit evaluates adherence to the health board guidelines for managing traumatic shoulder instability at Grange University Hospital.
Data from 100 patients presenting with native shoulder dislocations between January 2021 and February 2024 were analyzed. Clinical notes, radiological records, and procedural details were reviewed to assess compliance with imaging protocols, reduction procedures, and follow-up care.
The mean patient age was 44 years, with a female predominance of 52% (52 out of 100). Anterior dislocations constituted 83% of cases (83 patients), with posterior and inferior dislocations accounting for 16% (16 patients) and 1% (one patient), respectively. Manipulation under anaesthesia (MUA) was successful in 98% of cases (98 out of 100 patients), while 2% (two patients) required open reduction. Pre- and post-reduction imaging was performed in 97% of patients. Computed tomography (CT) and magnetic resonance imaging (MRI) were frequently used to assess associated injuries, which included Hill-Sachs lesions, greater tuberosity fractures, and rotator cuff tears. Neurological complications were identified in 28 patients (28%), primarily involving the axillary nerve. Posterior dislocations were more prevalent than typically reported, suggesting heightened diagnostic awareness.
This audit demonstrates strong compliance with established clinical protocols, reflected in high MUA success rates and effective identification of injury-related complications. However, areas for improvement have been identified to further improve clinical management and patient satisfaction.
肩关节脱位是我们急诊科最常见的大关节脱位，其中前脱位占绝大多数。这项回顾性审计评估了格兰奇大学医院在处理创伤性肩关节不稳定方面对健康委员会指南的遵循情况。
分析了2021年1月至2024年2月期间100例原发性肩关节脱位患者的数据。回顾了临床记录、放射学记录和手术细节，以评估对成像方案、复位程序和后续护理的依从性。
患者平均年龄为44岁，女性占比52%（100例中的52例）。前脱位占病例的83%（83例患者），后脱位和下脱位分别占16%（16例患者）和1%（1例患者）。98%的病例（100例患者中的98例）麻醉下手法复位（MUA）成功，2%（2例患者）需要切开复位。97%的患者进行了复位前后的成像检查。计算机断层扫描（CT）和磁共振成像（MRI）经常用于评估相关损伤，包括希尔-萨克斯损伤、大结节骨折和肩袖撕裂。28例患者（占28%）发现神经并发症，主要累及腋神经。后脱位比通常报道的更为普遍，这表明诊断意识有所提高。
这项审计表明对既定临床方案的依从性良好，这体现在高MUA成功率和对损伤相关并发症的有效识别上。然而，已确定了有待改进的方面，以进一步改善临床管理和患者满意度。
