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Incidence of Shoulder Dislocation in the United States Military: Demographic Considerations from a High-Risk Population
Brett D. Owens, MD1; Laura Dawson, DO1; Robert Burks, PhD2; Kenneth L. Cameron, PhD3
1 Division of Orthopaedic Surgery, William Beaumont Army Medical Center, 5005 North Piedras Street, El Paso, TX 79920. E-mail address for B.D. Owens: b.owens@us.army.mil
2 Center for Data Analysis and Statistics, U.S. Military Academy, West Point, NY 10996
3 Orthopaedic Research, Keller Army Community Hospital, 900 Washington Road, West Point, NY 10996
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Disclosure: The authors did not receive any outside funding or grants in support of their research for or preparation of this work. Neither they nor a member of their immediate families received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, division, center, clinical practice, or other charitable or nonprofit organization with which the authors, or a member of their immediate families, are affiliated or associated.
Disclaimer: The views expressed in this article are those of the authors and do not reflect the official policy of the Department of the Army, the Department of Defense, or the United States Government. The authors are employees of the United States Government. This work was prepared as part of their official duties and, as such, there is no copyright to be transferred.
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Investigation performed at the William Beaumont Army Medical Center, El Paso, Texas

The Journal of Bone and Joint Surgery, Inc.
J Bone Joint Surg Am, 2009 Apr 01;91(4):791-796. doi: 10.2106/JBJS.H.00514
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Background: Little is known of the incidence of shoulder instability, despite some evidence that it may be a common injury in young, athletic individuals. The goal of this study was to determine the incidence of shoulder dislocation in United States military personnel, as well as to identify the demographic risk factors for injury.

Methods: We performed a query of the Defense Medical Epidemiology Database with the code from the International Classification of Diseases, Ninth Revision, for acute shoulder dislocation for the years 1998 through 2006. An overall injury incidence was calculated, in addition to multivariate analysis, to determine independent risk factors among the following demographic considerations: sex, race, branch of military service, rank, and age.

Results: The overall incidence rate was 1.69 dislocations per 1000 person-years. Significant demographic risk factors were male sex, white race, service in the Army, junior enlisted rank, and an age of less than thirty years (p< 0.0001).

Conclusions: The incidence of shoulder instability among U.S. military personnel (1.69 per 1000 person-years) is considerably higher than previous reports for the general U.S. population (0.08 per 1000 person-years). Male sex, white race, and an age of less than thirty years were significant independent risk factors for injury.

Clinical Relevance: Shoulder dislocation is endemic in the military population. While this may not be generalizable to the general U.S. population, this incidence rate may be reflective of young, athletic cohorts. An improved understanding of the demographic groups at risk can be used to develop future preventive strategies.

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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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