Robinson C M, Seah K T M, Chee Y H, Hindle P, Murray I R
Edinburgh Shoulder Clinic, Royal Infirmary of Edinburgh, Old Dalkeith Road, Edinburgh EH16 4SA, UK.
J Bone Joint Surg Br. 2012 Jan;94(1):1-9. doi: 10.1302/0301-620X.94B1.27093.
Frozen shoulder is commonly encountered in general orthopaedic practice. It may arise spontaneously without an obvious predisposing cause, or be associated with a variety of local or systemic disorders. Diagnosis is based upon the recognition of the characteristic features of the pain, and selective limitation of passive external rotation. The macroscopic and histological features of the capsular contracture are well-defined, but the underlying pathological processes remain poorly understood. It may cause protracted disability, and imposes a considerable burden on health service resources. Most patients are still managed by physiotherapy in primary care, and only the more refractory cases are referred for specialist intervention. Targeted therapy is not possible and treatment remains predominantly symptomatic. However, over the last ten years, more active interventions that may shorten the clinical course, such as capsular distension arthrography and arthroscopic capsular release, have become more popular. This review describes the clinical and pathological features of frozen shoulder. We also outline the current treatment options, review the published results and present our own treatment algorithm.
肩周炎在普通骨科临床实践中较为常见。它可能无明显诱因自发出现，也可能与多种局部或全身性疾病相关。诊断基于对疼痛特征的识别以及被动外旋的选择性受限。关节囊挛缩的宏观和组织学特征已明确，但潜在的病理过程仍了解甚少。它可能导致长期残疾，并给卫生服务资源带来相当大的负担。大多数患者仍在初级保健中接受物理治疗，只有更难治的病例才会被转诊接受专科干预。由于无法进行针对性治疗，治疗仍主要以对症为主。然而，在过去十年中，一些可能缩短临床病程的更积极的干预措施，如关节造影下关节囊扩张术和关节镜下关节囊松解术，已变得更为普遍。本综述描述了肩周炎的临床和病理特征。我们还概述了当前的治疗选择，回顾了已发表的结果并提出了我们自己的治疗方案。
