Nazim Zeeshan Khan, Farhat M Farhan, Abbasi Saleem
Zeeshan Khan Nazim MS-Orthopedic and Trauma Surgery, Ex-Postgraduate Resident, Department of Orthopedics, PIMS, Islamabad, Pakistan.
Farhan Farhat MS-Orthopedic and Trauma Surgery, Ex-Postgraduate Resident, Department of Orthopedics, PIMS, Islamabad, Pakistan.
Pak J Med Sci. 2024 Aug;40(7):1415-1419. doi: 10.12669/pjms.40.7.8531.
To compare the efficacy of intra-articular steroid injection with ultrasound-guided supra-scapular nerve block in the management of frozen shoulder in terms of shoulder pain and disability index score and range of motion.
This randomized controlled trial was conducted in orthopedic department, PIMS, Islamabad from 1 January, 2020 to 30 June, 2020. A total of 72 patients were randomly equally (n=36 each) allocated to Group-A (intra-articular steroid injection) and Group-B (supra-scapular nerve block). Adults above 18 years of both genders having diffuse shoulder pain were included. Cases of shoulder pain localized because of bicipital tendinitis, rotator cuff tear, pain due to acute trauma and those with osteoarthritis were excluded. Data was analyzed in SPSS version 22.0.
Patients average age was 60.1 ± 6.29 in IASI and 58.0 ± 5.83 years in SSNB Group-And there were 19 (52.8%) males in IASI group compared to 15 (41.7%) in SSNB. At three weeks mean pain was significantly less in SSNB (57.1 ± 9.53 vs 49.4 ± 9.02) compared to IASI group (p-value, <0.001). The mean disability index was significantly low in SSNB (51.5 ± 5.10 vs 63.9 ± 5.14) versus IASI group (p-value, <0.001). At one week, three weeks and six weeks, mean external rotation was better in SSNB than IASI group (p-value, <0.001). The mean abduction was also better in SSNB group.
Ultrasound guided supra-scapular nerve block is better than intra-articular steroid injection in managing frozen shoulder.
比较关节内注射类固醇与超声引导下肩胛上神经阻滞在治疗肩周炎方面对肩部疼痛、残疾指数评分及活动范围的疗效。
本随机对照试验于2020年1月1日至2020年6月30日在伊斯兰堡巴基斯坦医学科学研究所骨科进行。共72例患者被随机平均分为A组（关节内注射类固醇）和B组（肩胛上神经阻滞），每组36例。纳入年龄在18岁以上、有弥漫性肩部疼痛的成年男女。因肱二头肌肌腱炎、肩袖撕裂、急性创伤疼痛及骨关节炎导致的肩部疼痛病例被排除。数据在SPSS 22.0版本中进行分析。
关节内注射类固醇组患者平均年龄为60.1±6.29岁，肩胛上神经阻滞组为58.0±5.83岁；关节内注射类固醇组有19例（52.8%）男性，肩胛上神经阻滞组有15例（41.7%）男性。与关节内注射类固醇组相比，三周时肩胛上神经阻滞组的平均疼痛明显减轻（57.1±9.53对49.4±9.02）（p值，<0.001）。肩胛上神经阻滞组的平均残疾指数明显低于关节内注射类固醇组（51.5±5.10对63.9±5.14）（p值，<0.001）。在一周、三周和六周时，肩胛上神经阻滞组的平均外旋角度优于关节内注射类固醇组（p值，<0.001）。肩胛上神经阻滞组的平均外展角度也更好。
在治疗肩周炎方面，超声引导下肩胛上神经阻滞优于关节内注射类固醇。
