Evidence-Based Answers

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Word of the Day

6% of patients with shoulder dislocations have fracture; rate varies with age

Clinical Question:
How often do patients with acute shoulder dislocations have a co-existing fracture?

Bottom Line:
Overall, the rate of fractures in patients with shoulder dislocations is low, but varies greatly by age. These data can be used to guide decisions about the use of pre-reduction radiographs. (LOE = 3b)

Orloski J, Eskin B, Allegra PC, Allegra JR. Do all patients with shoulder dislocations need prereduction x-rays? Am J Emerg Med 2011;29(6):609-612.  [PMID:20825841]

Study Design:
Cohort (retrospective)

Unknown/not stated

Emergency department

These authors used a billing database to identify more than 7000 patients with shoulder dislocations seen in 19 emergency departments over a 10-year period. They reviewed the x-ray reports to determine if a fracture was present. Overall, 465 of the patients (6.5%) had a fracture. All of the fractures were humeral; none involved the scapula. The rate of fractures varied by age, as follows: Age (Years) Fracture Rate (%) 0-9 7 10-19 <1 20-29 <1 30-39 3 40-49 5 50-59 14 60-69 15 70+ 20


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