Management of the stiff shoulder.

摘要: Shoulder stiffness occurs as a result of (1) contractures the intraarticular capsule or muscle–tendon units (2) adhesions within extraarticular humeroscapular scapulothoracic motion interface. These may occur independently in combination. A thorough history and physical examination usually reveal diagnosis (idiopathic frozen shoulder posttraumatic stiff shoulder) anatomical locations fibrosis that is causing stiffness, identifies other treatable conditions associated with (such diabetes). gentle home program passive stretching effective most patients. When not effective, manipulation surgical release be indicated. If capsular are best released arthroscopically this allows circumferential without damaging rotator cuff thus rehabilitation need to protect cuff. The interface can either open arthroscopically, but we believe an combined arthroscopic quicker does interfere rehabilitation. necessary, operative management coupled aggressive provide significant relief pain restoration motion. Approximately 90% patients expect good treatment algorithm.