手法松解与液压扩张治疗冻结肩之对比观察

目的：进一步提高冻结肩的治疗效果，缩短疗程，减少并发症。方法：４４个冻结肩进行臂丛麻醉下一次性手法松解，另４４个冻结肩进行局麻下肩关节腔内液压扩张治疗，比较２种治疗方法的效果及优缺点。结果：随访时间８～２２个月。手法松解组，优９５５％，平均康复时间１４周，２例患者出现麻醉并发症；液压扩张组，优７７３％，平均康复时间１０周，无并发症出现。２组病例轻中型疗效无明显差别（Ｐ＞００５），重型病例疗效差异显著（Ｐ＜００５）。结论：轻中型冻结肩及伴有严重肩部骨质疏松者宜首选液压扩张疗法治疗；重型病例运用手法松解疗法效果更佳。

Comparison of Manipulation Release and Hydraulic Distension for Treatment of Frozen Shoulder

Objective:To improve the effect of the treatment for frozen shoulder and to reduce the course of recovery.Methods:44 frozen shoulders were treated by manipulation release under brachial plexus anesthesia and another 44 frozen shoulders with hydraulic distension under local anesthesia.These two sorts of therapy were compared for their treatment outcomes,as well as their advantages and disadvantages.Results:All the cases were followed up from 8 to 22 months.In the group of manipulation relaese,42 shoulders were excellent,the course of recovery was in average of 14 weeks.The complications of anesthesia occurred in 2 cases.In the group of hydraulic distension,34 shoulders excellent,the course of recovery 10 weeks.No complication occurred.The slight and moderate cases of the two groups had the same effect,but the severe cases by manipulation had a better effect than with hyduaulic distension.Conculsion:Hydraulic distension should be considered firstly in the management of the sli release should be applied to the severe cases.