Implementation of Quebec Shoulder Dislocation Rule in Turkish patient population

Background: The aim of this study was to investigate whether the Quebec Shoulder Dislocation Rule is valid in Turkish patient population.
Methods: Adult patients with an anterior shoulder dislocation were enrolled in this study. Patients with a severe head injury, multipl trauma and drug or alchol intoxication were excluded. All patients were classified according to the associated fracture status. Patients with fracture-dislocation were classified as ‘case’ group (group 1) and patients with isolated dislocation were included to the ‘control’ group (group 2). Group 1 and 2 patients were statistically compared in terms of risk factors defined by Quebec dislocation rule. Diagnostic performance of this decision tool in predicting a clinically significant fracture was studied. Sensitivity, specifity, positive predictive value and negative predictive value were calculated.
Results: A total of 248 patients were included in the study. Fracture-dislocation was detected in 63 (25.40%) patients (group 1) and noncomplicated dislocation was detected in 185 (74.59%) patients (group 2). Statistically significant difference was found between group 1 and 2 in terms of risk factors defined by Quebec dislocation rule. Sensitivity, Specificity, positive and negative predictive value of the Quebec rule were detected as 100%, 33.51%, 33.87% and 98.41% respectively.
Conclusion: Our study suggests that Quebec Shoulder Dislocation Rule is a useful decision tool to estimate which patient have fracture-dislocation of the shoulder in Turkish population. We think that if a shoulder dislocation patient is ‘Quebec -’, prereduction X-Ray could be safely ommited.