Guan Haitao, Wu Qinfeng, Zhou Yuan, Fan Xing, Zheng Kun, Si Tong, Zhao Jinli
Department of Ultrasonography, Suzhou Science / Technology Town Hospital, Suzhou, China.
Department of Ultrasonography, Nantong Third People's Hospital, Nantong, China.
Front Surg. 2022 Oct 18;9:998590. doi: 10.3389/fsurg.2022.998590. eCollection 2022.
To investigate the clinical value of ultrasound (US)-guided intervention for frozen shoulder (FS) in the frozen stage.
This study included 40 patients who had primary FS in the frozen stage and were evaluated by US. These 40 patients have all received conservative treatment elsewhere, and no satisfactory results have been achieved, with no improvement in active and passive movement angles, and no improvement in scores within 3 months. Therefore, their previous treatment was set as comparison. All patients underwent US-guided shoulder joint capsule distension by injection of sterilized water. Of these participants, 22 patients with scapulohumeral periarthritis received a compound betamethasone injection, and 14 patients with thickened coracohumeral ligaments (CHLs) underwent acupotomy lysis, and the remaining 4 patients had no extra treatments. The Constant-Murley score (CMS) was evaluated before and after the operation and analysed for each patient.
Before treatment, the indices for the thickening of the subaxillary joint capsule, subacromial bursa (with or without effusion), long head of the biceps brachii tendon (LHBBT) and CHL were 40, 22, 16 and 14, respectively. After treatment, all the indices were significantly decreased (all < 0.010) except for that of the LHBBT ( = 0.123). The patients' CMSs improved, with the median total CMS increasing from 59 points (interquartile range: 53-64 points) to 86 points (interquartile range: 78-90 points) ( < 0.010). While the internal rotation (Ir) of the shoulder joint did not improve (FDRs < 0.50), abduction, forward flexion (Ff) and external rotation (Er) improved significantly (all FDRs = 1.00).
Compared with conservative treatment, US-guided intervention for FS in the frozen stage is highly effective and of great clinical value.
探讨超声（US）引导下干预冻结期肩周炎（FS）的临床价值。
本研究纳入40例冻结期原发性FS患者并接受超声评估。这40例患者均在其他地方接受过保守治疗，但未取得满意效果，主动和被动活动角度无改善，3个月内评分无提高。因此，将他们之前的治疗作为对照。所有患者均接受超声引导下向肩关节囊内注射无菌水进行扩张。其中，22例肩肱关节周围炎患者接受复方倍他米松注射，14例喙肱韧带（CHL）增厚患者接受针刀松解，其余4例未接受额外治疗。对每位患者在手术前后进行Constant-Murley评分（CMS）评估并分析。
治疗前，腋关节囊增厚、肩峰下滑囊（有无积液）、肱二头肌长头肌腱（LHBBT）和CHL的指标分别为40、22、16和14。治疗后，除LHBBT指标外（=0.123），所有指标均显著降低（均<0.010）。患者的CMS有所改善，总CMS中位数从59分（四分位间距：53 - 64分）增至86分（四分位间距：78 - 90分）（<0.010）。虽然肩关节内旋（Ir）未改善（FDRs<0.50），但外展、前屈（Ff）和外旋（Er）显著改善（所有FDRs = 1.00）。
与保守治疗相比，超声引导下干预冻结期FS疗效显著，具有重要临床价值。
