50 patients with anterior shoulder dislocation were randomized to receive sling immobilization in either external or internal rotation for the purpose of comparing recurrent dislocation and healing rate of labral lesions (when present) over a 24-month follow-up period. The results demonstrated that recurrence and healing rates were comparable between immobilization groups. However, a subgroup analysis of patients aged 20 to 40 years revealed a significantly reduced recurrence rate in the external group when compared to the internal group at 24 months. The results of this subgroup analysis should be interpreted with caution as the sample of patients and event rates were small.