麻醉下推拿松解整体疗法和单纯推拿手法治疗肩关节周围炎临床研究

目的:观察麻醉下推拿松解整体疗法与单纯推拿手法治疗肩关节周围炎的临床疗效。方法:选取本院2015年1月—2016年1月收治的肩周炎患者84例,随机分为对照组与研究组,各42例。对照组给予传统推拿手法治疗,研究组给予麻醉下推拿松解整体疗法治疗。结果:研究组治疗后上举、外展、内旋、外旋活动度均优于对照组(P0.05);研究组治疗后ADL评分优于对照组(P0.05);对照组有效率为85.71%,研究组有效率为92.86%,研究组优于对照组(P0.05)。结论:与单纯推拿手法治疗比较,麻醉下推拿松解整体疗法治疗肩关节周围炎疗效确切,更利于患者肩关节活动和生活能力的改善。     

Outcome of manipulation under anesthesia with or without intra-articular steroid injection for treating frozen shoulder: A retrospective cohort study

Manipulation under anesthesia (MUA) combined with intra-articular steroid injection (ISI) is preferred in management of the refractory frozen shoulder (FS). This study aimed to evaluate the effect of MUA with ISI or not on pain severity and function of the shoulder.Data on 141 patients receiving MUA with primary FS refractory to conservative treatments for at least 1 month were retrospectively obtained from medical records. We performed propensity score matching analysis between patients receiving MUA only and those receiving MUA plus ISI, and then conducted logistic regression analysis to identify the risk factors for the need to other treatments during 6-month follow-up.More improvement in terms of the SPADI pain scores and passive ROM at 2 weeks after first intervention remained in patients receiving MUA plus ISI after matching. The need to other treatments during 6-month follow-up occurred in 10.6% patients (n = 141). Logistic regression analysis revealed that a repeat MUA 1 week after first intervention was a protective factor (OR 0.042; 95% CI 0.011–0.162; P = .000) and duration of disease was the only one risk factor (OR 1.080; 95% CI 1.020–1.144; P = .008) for the need to other treatments during follow-up.ISI immediately following MUA provided additional benefits in rapid relief of pain and disability for patients with refractory FS. Pain and disability of the shoulder may be rapidly alleviated by an earlier MUA from the onset of the symptoms and a repeat MUA 1 week after first intervention.     

FIESTA: An MR arthrography celebration of shoulder joint anatomy,variants, and their mimics

Magnetic resonance (MR) arthrography is currently the gold standard radiological investigation for shoulder joint instability. Not only does this investigation allow for identification of important disease processes, but the reduced slice thickness and increased in‐plane resolution allowed by the latest imaging sequences also gives excellent demonstration of shoulder joint internal anatomy. This article describes the technique of MR arthrography of the shoulder practiced at our institution, briefly outlining features of the FIESTA (fast imaging employing steady state acquisition) MR sequence employed, including its advantages and limitations. A pictorial review of shoulder MR arthrography performed with this technique is presented, concentrating on normal shoulder joint internal anatomy and anatomical variants that may mimic pathology. Clin. Anat., 2013. © 2012 Wiley Periodicals, Inc.     

Clinical anatomy of the subacromial and related shoulder bursae: A review of the literature

The subacromial bursa (SAB) is the main bursa of the shoulder. It facilitates normal movement and is also commonly involved in shoulder disorders. Other shoulder bursae have been described but their anatomy has not been well studied. Anatomical variation of shoulder bursae has been suggested and this has implications for clinical practice. This article reviews current knowledge of the normal anatomy of the SAB and related shoulder bursae. A systematic review of the English and German literature was conducted using databases and a hand search of reference lists focusing on the clinical anatomy of the SAB, coracobrachial and subcoracoid bursae and subtendinous bursa of subscapularis. Twenty‐four original sources and 13 textbooks were identified. Fifteen studies described the general morphology of the shoulder bursae using cadaveric specimens, eight examined innervation, and one provided information about the blood supply of the SAB. The literature agrees that the SAB is consistent and well innervated with a lateral subdeltoid part and a variable subcoracoid portion. There is variability regarding the consistency, location, and communications of the coracobrachial and subcoracoid bursae and the superior part of the subtendinous bursa of subscapularis, and little information on their nerve and blood supply. Several bursae are present around the shoulder joint. Further research is warranted to understand the precise attachments, dimensions, and communications of the bursae, as well as their nerve and blood supply. This information will improve understanding of the clinical relevance of these bursae and inform appropriate assessment and treatment. Clin. Anat. 30:213–226, 2017. © 2017 Wiley Periodicals, Inc.