Transient brachial plexus block after shoulder manipulation: A case report

Abstract

ASE REPORT A 40-year-old right hand–dominant female nurse had a -month history of adhesive capsulitis of the left shoulder. he was diagnosed as having a primary frozen shoulder ithout any inciting event and a normal clinical examinaion other than global restriction of range of motion. Radioraphic examination of the shoulder was normal. Conserative rehabilitative physiotherapy together with analgesia ad been tried with little clinical improvement. She was a onsmoker, had no history of diabetes, and had no other oncurrent illness. After failure of conservative treatment, it as believed that she would benefit from manipulation nder general anesthesia followed by instillation of local nesthetic and steroid in the glenohumeral joint. On examination with the patient under general anestheia, a restricted passive range of motion of the shoulder was ecorded—that is, external rotation of 10°, forward flexion f 45°, and abduction of 45°. A manipulation was then erformed by use of the short lever arm, scapula-stabilizing ethod of Beacon et al. A positive separation of the dhesive capsulitis was palpable and audible, allowing an lmost complete range of motion of the shoulder with minmum force. This was followed by an intraarticular injection