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原发性冻结肩的关节内注射、肩峰下注射及液压扩张术:一项随机临床试验

Intra-articular injection, subacromial injection, and hydrodilatation for primary frozen shoulder: a randomized clinical trial.

作者信息

Yoon Jong Pil, Chung Seok Won, Kim Ju-Eun, Kim Hyung Sup, Lee Hyun-Joo, Jeong Won-Ju, Oh Kyung-Soo, Lee Dong-Oh, Seo Anna, Kim Youngjun

机构信息

Department of Orthopaedic Surgery, School of Medicine, Kyungpook National University, Daegu, South Korea.

Department of Orthopaedic Surgery, School of Medicine, Konkuk University, Seoul, South Korea.

出版信息

J Shoulder Elbow Surg. 2016 Mar;25(3):376-83. doi: 10.1016/j.jse.2015.11.009.

Abstract

BACKGROUND

The aim of this prospective randomized study was to compare the efficacy of 3 injection methods, intra-articular injection, subacromial injection, and hydrodilatation (HD), in the treatment of primary frozen shoulder.

METHODS

Patients with primary frozen shoulder were randomized to undergo intra-articular injection (n = 29), subacromial injection (n = 29), or HD (n = 28). Evaluations using a visual analog scale for pain, Simple Shoulder Test, Constant score, and passive range of shoulder motion were completed before treatment and 1 month, 3 months, and 6 months after treatment.

RESULTS

Among the 3 injection methods for primary frozen shoulder, HD resulted in a greater range of motion in forward flexion and external rotation, a lower visual analog scale score for pain after 1 month, and better outcomes for all functional scores after 1 month and 3 months of follow-up. However, there were no significant differences in any clinical outcomes among the 3 groups in the final follow-up at 6 months.

CONCLUSIONS

Although HD yielded more rapid improvement, the 3 injection methods for primary frozen shoulder resulted in similar clinical improvement in the final follow-up at 6 months.

摘要

背景

这项前瞻性随机研究的目的是比较三种注射方法(关节内注射、肩峰下注射和液压扩张术(HD))治疗原发性冻结肩的疗效。

方法

将原发性冻结肩患者随机分为关节内注射组(n = 29)、肩峰下注射组(n = 29)或液压扩张术组(n = 28)。在治疗前以及治疗后1个月、3个月和6个月,使用视觉模拟疼痛量表、简易肩部测试、Constant评分和肩部被动活动范围进行评估。

结果

在原发性冻结肩的三种注射方法中,液压扩张术在1个月后前屈和外旋活动范围更大,疼痛视觉模拟量表评分更低,且在随访1个月和3个月后所有功能评分的结果更好。然而,在6个月的最终随访中,三组之间的任何临床结果均无显著差异。

结论

尽管液压扩张术改善更快,但原发性冻结肩的三种注射方法在6个月的最终随访中临床改善相似。

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