Abstract
Purpose:This study examined the effectiveness of manipulation under ultrasound-guided brachial plexus block in patients with recalcitrant idiopathic frozen shoulder and diabetic secondary frozen shoulder (diabetic frozen shoulder).Methods:Forty-four idiopathic frozen shoulders and 10 diabetic frozen shoulders with failed conservative treatment for at least 3 months were included in this study. The manipulation was performed under ultrasound-guided brachial plexus block and visual analogue scale, range of motion, and Constant scores were measured before manipulation and at the last follow-up examination.Results:No major complications were observed during the procedure. Sufficient improvement was not obtained in two patients during the procedure and to avoid complications, the procedure was discontinued and subsequently arthroscopic capsular release was performed. Visual analogue scale, range of motion towards all directions, and Constant scores were significantly improved after the manipulation in both the idiopathic frozen shoulder and diabetic frozen shoulder groups, however the diabetic group showed inferior results compared with those of the idiopathic group.Conclusion:This manipulation was effective and shortened the duration of symptoms in most of the idiopathic and diabetic frozen shoulders without major complications during the procedure. Diabetic frozen shoulder showed inferior clinical results and difficulty in recovery in range of motion, which indicated that diabetic frozen shoulder should be discussed as a different entity.
Highlights
Frozen shoulder is considered to be self-limiting or to recover with or without treatments, but full restoration in range of motion is not always obtained
The therapeutic value of manipulation under general anesthesia was well reported to shorten the duration of symptoms and recent studies showed that this technique was safer than previously reported when adequate caution was paid for the complications [11 - 13]
The findings of this study indicated that both idiopathic and diabetic groups were successfully managed with this procedure; the diabetic group showed the inferior recovery of Visual analogue scale (VAS), range of motion, and Constant scores compared with the idiopathic group
Summary
Frozen shoulder is considered to be self-limiting or to recover with or without treatments, but full restoration in range of motion is not always obtained. Almost fifty percent of patients with frozen shoulder had some ongoing symptoms even after a few years of conservative treatments, the persistent symptoms are commonly mild [1, 2] Etiology of this condition is still unclear and subjects of controversy, but various treatment modalities to decrease. The therapeutic value of manipulation under general anesthesia was well reported to shorten the duration of symptoms and recent studies showed that this technique was safer than previously reported when adequate caution was paid for the complications [11 - 13] Others claimed that it had little effectiveness and an arthroscopic capsular release should be considered [6, 9, 14, 15]. Recent development of ultrasound technology enabled us to perform brachial plexus or cervical nerve root block safely and effectively, but the effectiveness of manipulation under local anesthesia is little reported [16 - 18]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
