Evidence-base Study About Secondary Frozen Shoulder After Trauma Of Shoulder

Objective: Evidence-base study about the secondary frozen shoulder after treatment with different methods of shouler trauma.to discuss the cause which due to the secondary frozen shoulder,to discuss how to prevent and deal with it ,then give advice to functional exercise,and provide evidence-base proof for clinical research.Methods: This study is retrospective reseach ,From January, 2007 to February, 2010, 262 patients who were shouler trauma containing proximal humerus fracture, Neer type II distal clavicle fracture, Rockwood type III acromioclavicular dislocation, shoulder dislocation(without rotator cuff injury).There were 144 men and 118 wowen treated in the The Second Affiliated Hospital of Soochow University during the period, The average age of patients was 47.8 years old(from 14 to 96 years old), they were devided into operation treatment and conservative treatment, The Adjusted Constant-Murley Scare system(except power testing,duo to the differerce of sex and age which are relevant to the score ) was observed to evaluate the function recover,and then give advice to functional exercise.with the help of SPSS17.0 software.We can compare the difference of the score and the rate belonging to different trauma and scale. According to the result,we can find the cause of secondary frozen shoulder,and find the good functional exercise,prevention,clinical scale.Results: There were 60 cases in the 262 patients which were secondary frozen shoulder. 21 cases in the 45 patients who were proximal humeral fracture patients were secondary frozen shoulder, 11 cases in the 29 patients who treated with plates were secondary frozen shoulder, the rate of secondary frozen shoulder which was caused by treatment with plates was 37.9%; 10 cases in the 16 patients who treated with conservative method were secondary frozen shoulder, the rate of secondary frozen shoulder which was caused by conservative treatment with plates was 62.5%;the difference of score between operation and conservative treatment in the proximal humerus fracture was manifest(P<0.05). 18 cases in the 142 patients who were Neer type II distal clavicle fracture patients were secondary frozen shoulder, 18 cases in the 112 patients who treated with hook plates were secondary frozen shoulder, the rate of secondary frozen shoulder which was caused by treatment with hook plates was 16.1%; there was no patient who treated with conservative method was secondary frozen shoulder, the difference of score between operation and conservative treatment in the Neer type II distal clavicle fracture was manifest(P=0.01). 9 cases in the 45 patients who were Rockwood type III acromioclavicular dislocation patients were secondary frozen shoulder, 6 cases in the 30 patients who treated with hook plates were secondary frozen shoulder, the rate of secondary frozen shoulder which was caused by treatment with hook plates was 20.0%; 3 cases in the 15 patients who treated with conservative method were secondary frozen shoulder, the rate of secondary frozen shoulder which was caused by conservative treatment with plates was 20.0 % ;the difference of score between operation and conservative treatment in the Rockwood type III acromioclavicular dislocation was not significant (P>0.05). 12 cases in the 30 shoulder dislocation patients who treated with conservative method were secondary frozen shoulder, the rate of secondary frozen shoulder which was caused by conservative treatment with plates was 20.0%.Conclusion: Secondary frozen shoulder after shoulder trauma and treatment has a high incidence rate and has effected on the function recover of shoulder. There are not good methods to deal with it.The reasonable functional exercise,prevention and clinical scale is very important.