Epidemiology of shoulder dislocation at Chris Hani Baragwanath Academic Hospital over a one-year period

Abstract

INTRODUCTION: Anterior shoulder dislocation is the commonest clinical presentation of gleno-humeral joint instability. Shoulder dislocation incidence of 56.3 per 100 000 person-years have been reported. This is associated with morbidity and heavy burden on the country’s healthcare system. This study aims to investigate the epidemiology of shoulder dislocations at Chris Hani Baragwanath Academic Hospital (CHBAH). METHODOLOGY: Our study was a retrospective analysis of records of patients who presented at the Orthopaedic trauma unit at CHBAH with shoulder dislocations during the period of 01 June 2016 to 31 May 2017. Our study’s main outcome measures were shoulder dislocations and associated injuries. Ethics approval was granted by the Human Research Ethics Committee (HREC) (Medical), University of the Witwatersrand prior to data collection. Moreover, permission to conduct the study was obtained from the Chief Executive Officer (CEO) at CHBAH prior to data collection. RESULTS: The incidence of shoulder dislocations was found to be 34.9%. Most of our patients were males with a mean age of 43.5 years. Patients in the age-group 21 to 40 years accounted for the majority of all the dislocations (45.4%). We observed that approximately two-thirds of the shoulder dislocations occurred in the colder months (Autumn & Winter seasons) and less than one-tenth of the patients required admissions. Anterior dislocationsaccounted for the majority of the cases (99.4%). Most of the dislocations were on the right shoulder (56.9%) and about a tenth of these patients with shoulder dislocations also had associated fractures; the humerus being the most affected bone. CONCLUSION: Our study found that, although the majority of dislocations were found in young active males, in patients older than 60 years, females had a higher dislocation rate in comparison to their male counterparts. Efforts to improve safety in these elderly patients (> 60 years) require prioritisation to reduce shoulder injuries in this high-risk group.