The epidemiology of shoulder dislocations in Malaysia

The case notes of 102 patients (117 shoulder dislocations) were reviewed retrospectively to improve the understanding of the epidemiology of this common injury. Eighty-one dislocations were primary and 36 dislocations were second or recurrent dislocations. The age distribution was characterized by a peak in male patients aged between 21-30 years. The mean age for males was 30.5 years and 47.7 years for females. The male:female ratio in first time dislocations was 5:2, while it was 5:1 in recurrent dislocations. Ninety-eight percent were anterior dislocations and 2% were posterior dislocations. Greater tuberosity fractures were found in 17 patients and almost half of these patients were aged between 41-50 years. The most common cause of first time dislocation was a direct blow or fall onto the shoulder, accounting for 42 patients (55%). The majority of these patients were aged 40 years and above. Next common cause was motor vehicle accident which occurred mostly in the younger age group. Dislocations due to sporting injuries accounted for only 5.3% of all first time dislocations. Nearly 97% were successfully reduced without a general anaesthesia. Seventy-seven percent of the patients had their shoulders immobilized after reduction, mostly with body strapping only. Fifteen patients (14.7%) were referred for physiotherapy for stiffness. Few operations were performed for recurrent dislocations but surgery does not appear to be well accepted as yet by our patients.