A capsular dilatation facilitated shoulder manipulation for treating patients with frozen shoulder.
Forty patients with a diagnosis of frozen shoulder who had symptom for an average of 8 months and failed conservative treatment of at least 6 weeks of physical therapy were treated with capsular dilatation facilitated shoulder manipulation. Post-manipulation, the patient underwent arthroscopy for visualization, fibrin debridement and bleeding point coagulation. All the essential intra-articular structures ie, glenohumeral ligament, rotator cuff were intact. Post-operatively, all patients revealed substantial gain in shoulder range of motion as well as diminished shoulder pain. The average flexion, abduction, and internal rotation gain were 76.9+/-8.9, 18.1+/-5.7, 9.6+/-7.1 degrees respectively. External rotation gain in the position of 90 degrees shoulder abduction and shoulder adduction were 53.0+/-9.97 and 31.4+/-7.2 degrees respectively. The average pain score by visual analogue scale pre and 6-month post-manipulation were 80.6+/-8.6 and 7.6+/-7.3 respectively with the average of pain score of 73.0+/-10.4. The authors proposed an effective and safe technique employing intra-articular pressure to facilitate shoulder manipulation in order to treat frozen shoulder.
Department of Orthopedics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Somsak
S
Kuptniratsaikul
Vilai
V
Kuptniratsaikul
Tawechai
T
Tejapongvorachai
Pibul
P
Itiravivong
D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017746:Joint Capsule; D007592:Joint Diseases / Q000175:diagnosis / Q000534:rehabilitation*; D008297:Male; D008349:Manipulation, Orthopedic / Q000379:methods*; D008875:Middle Aged; D010147:Pain Measurement; D026741:Physical Therapy Modalities; D011336:Probability; D011446:Prospective Studies; D016059:Range of Motion, Articular / Q000502:physiology*; D020127:Recovery of Function; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D012785:Shoulder Joint / Q000503:physiopathology*; D016896:Treatment Outcome