Conservative treatment of first-time shoulder dislocation with the arm in external rotation.

Nonoperative treatment of traumatic first-time shoulder dislocation has remained the same for a long time. The recurrence rate of nonoperative treatment is unacceptably high, especially in young and active patients. In an earlier study, we demonstrated the superiority of immobilization in external rotation over conventional treatment. Arthroscopic stabilization is being increasingly recommended after a first-time dislocation; however, surgical stabilization after a first-time dislocation still remains controversial. In this paper, we introduce a basic study that provides evidence for the development of immobilization in external rotation, recent clinical outcomes, and future perspective. Furthermore, how to choose the treatment options for first-time dislocations is discussed.