液压扩张疗法治疗冻结肩的临床研究

A Clinical Study of Treatment for Frozen Shoulder With Hydraulic Pressure Distension

目的 探讨液压扩张疗法对冻结肩的治疗价值,分析影响治疗效果的相关因素。方法 对43 例(44 肩)冻结肩进行了局麻下关节囊内液压扩张治疗,并对其中19 肩进行了扩张造影。结果 随访时间8 ～16 个月。根据作者拟定的冻结肩的分型及疗效评定标准,44 肩中优34 肩,良10肩。其中轻型7 肩疗效均为优;中型18 肩:优17 肩,良1 肩;重型19 肩:优10 肩,良9 肩。19 肩扩张造影结果显示∶扩张治疗后关节囊内显影有不同程度的改善,容积平均增加6 ml。结论 (1)液压扩张疗法是治疗冻结肩的有效方法,尤其对轻、中型患者疗效显著;(2) 对明显外伤或手术引起的冻结肩疗效可能不理想;(3) 操作技术是影响疗效的直接因素;(4)

Objective To investigate the outcome of frozen shoulders treated by hydraulic pressure distension, and to analyse the factors affecting the results. Methods 43 cases with frozen shoulders (44 shoulders) were treated by hydraulic pressure distension, 19 shoulders were performed by distension arthrography. According to the authors criteria, the patients were divided into three groups, and three levels were designed to assess the effect. Results The follow up period ranged from 8 to 16 months. Excellent results were obtained in 34 shoulders, good in 10 shoulders.In the slight stiffness group (7 shoulders), excellent in 7,in the moderate group (18 shoulders), excellent in 17 and good in 1,in the severe group (19 shoulders),excellent in 10 and good in 9 . Distension arthrography of 19 frozen shoulders showed that average increase in capsular capacity was 6 ml. Conclusion Hydraulic pressure distension is a reliable and highly effective treatment for frozen shoulders in the slight or moderate stiffness group, but it was less effective for those in the severe stiffness group. A failed result was seen in the post traumatic stiff shoulders. The technique may be a factor affecting the results and the course of the illness does not seem to influence the results of the treatment.