Contracture of the shoulder joint

Area of Science:

• Orthopedics
• Rheumatology
• Physical Medicine and Rehabilitation

Background:

• Shoulder joint contracture, also known as frozen shoulder, causes significant movement limitation.
• Post-traumatic or inflammatory changes in the shoulder or surrounding tissues are common causes.
• Delayed treatment can lead to shrinkage of articular and periarticular tissues, complicating recovery.

Purpose of the Study:

• To evaluate the effectiveness of different treatment modalities for shoulder joint contracture.
• To assess outcomes of manipulation under anesthesia and surgical revision for frozen shoulder.

Main Methods:

• Routine treatment involves arm positioning in abduction and active/passive mobilization exercises.
• Manipulation of the shoulder joint under general anesthesia was performed for delayed treatment cases.
• Surgical revision with excision of scarified tissues was conducted for patients unresponsive to manipulation.

Main Results:

• Manipulation under anesthesia successfully restored full joint motion in the majority of patients with delayed treatment.
• Surgical revision provided adequate, though not total, range of motion restoration in non-responders to manipulation.
• Both interventions aimed to overcome limitations caused by shrunken periarticular and articular tissues.

Conclusions:

• Manipulation under anesthesia is a highly effective treatment for frozen shoulder, especially in cases with significant tissue shrinkage.
• Surgical intervention offers a viable option for restoring shoulder mobility when manipulation fails.
• Early and appropriate treatment is crucial for optimal outcomes in managing shoulder joint contracture.