Abstract
Objective: To evaluate the result of treatment of frozen shoulder by Hydraulic Distention under local anesthesia with steroid and intra-articular steroid alone. Study Design: It was a prospective and comparative study. Samples size: 60 patients were taken in this study and were divided into two groups. Duration and Setting: The study was conducted in 2000 - 2001 treated in the department of Orthopaedic, Mayo Hospital Lahore. Methodology: The patients were divided into two groups. Group-I were treated by hydraulic distension of glenohumeral joint with 50 ml normal saline under local anesthesia with steroid followed by medicines (oral analgesics and muscle relaxants) and exercises. Patients in group-II were treated by intra-articular steroid followed by medicines (oral analgesics and muscle relaxants) and exercises. Results: The average age of patients in group I was 52 ± 2.16 years and 50 ± 2.03 in group II. There were 37 (63%) females and 22 (37%) males in our study. Female to male ratio was 1.7:1. All patients in group-I noted immediate pain relief with excellent return of range of motion (ROM) and resumption of normal sleep. At the end of 45 days of follow up all patients had returned to their normal daily activities. Most of them got excellent ROM and pain relief. All patients in group-II noted immediate pain relief and resumption of almost normal sleep. At the end of 45 days of follow up most of the patient presented with good relief of pain but could not return to most of their normal activities because of less improvement in ROM. Conclusions: Hydraulic distension technique is a quick, safe and gives early results, so it should be considered first for the treatment of frozen shoulder. Key Words: Frozen Shoulder, Hydrologic Distention, Intra articular steroid.
Highlights
Frozen shoulder is a chronic fibrosing condition of the capsule of the shoulder joint.[1]
ZuCkerman and Cuomo defined frozen shoulder, or adhesive capsulitis, as a condition of uncertain etiology characterized by substantial restriction of both active and passive shoulder motion that occurs in the absence of a known intrinsic shoulder disorder.[3]
Group-I were treated by hydraulic distension of glenohumeral joint with 50 ml normal saline under local anesthesia with steroid followed by medicines and exercises
Summary
Frozen shoulder is a chronic fibrosing condition of the capsule of the shoulder joint.[1] The term frozen shoulder as first used by Codman 1932 who described the common features as a pain of gradual onset, which is felt near the insertion of the deltoid, inability to sleep on the affected side, painful restriction of elevation and external rotation and a normal radiological appearance.[1,2] He stated that most cases resolved in about two years without treatment. The cause of frozen shoulder remains enigmatic.[2] Naviasor (1945) suggested a chronic inflammatory condition Lundberg (1969) suggested that the primary pathology was fibrosis & fibroplasias.[2] Recently arthroscopic studies showed that the capsule was contracted, there were no adhesions and that the maximal area of abnormality was at the rotator interval.[1] Frozen shoulder has been divided into three stages depending on its symptoms
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