肩关节造影及液压扩张疗法治疗冻结肩的临床研究

A clinical study of the arthrography and treatment with hydraulic distension for frozen shoulder

目的 探讨肩关节造影及液压扩张法治疗冻结肩的关节造影表现、评价治疗作用和影响疗效的相关因素,材料和方法 对19例经我院骨科确诊为冻结肩的病人进行肩关节造影并同时进行液压扩张治疗,观察造影表现和临床随诊、评价其症状缓解和关节功能恢复情况。结果 19例冻结肩均有关节容量的缩小,平均容量仅6.5ml,其中腋隐窝缩小、消失者14肩(73％);肱二头肌长头腱鞘不显影或充盈不良者15肩(79％);肩胛下肌下滑囊缩小者10肩(53％);关节囊边缘不规整者7肩(37％)。液压扩张治疗优效率:轻、中型100％,重型70％。结论 液压扩张疗法治疗冻结肩,并辅以积极的术后功能锻练是安全、经济而有效的方法,能达到缓解临床症状、恢复关节功能的目的。

Objective To investigate arthrography manifestations of frozen shoulder andtreatment with hydraulic distension for frozen shoulder. Methods 19 cases with frozen shoulder diagnosed by orthopod were studied with arthrography and treated with hydraulic distension at same time in order to evaluate the arthrography manifestation and effect of hydraulic distension therapy. Results Distension arlhrography was performed in 19 cases. The decrease joint capacity was observed in all patients (average 6.5ml, 100%), the axillary recesses were absent or very small in 14 cases (73%). the biceps london sheath filled poorly or not at all in 15 cases (79%), the subscapularis reduced in 10 cases(53% ), and the capsule unregular was observed in 7 cases (37%) . In slight and moderate stiffness group (9 eases), the rate of excellent was 100%. In severe stiffness group(10 cases), the rate of excallent was 70%. Conclusion Hydraulic distension is a safe, reliable and effective treatment for frozen shoulder. Distension arthrography can not only establish diagnosis, but also help further understanding the mechanism of hydraulic distension for the frozen shoulder.