| Frozen sholder is a commom disease of shoulder with limition of shoulder function and shoulder pain,that often occurs in the40-65age group and is More women than men, and clinically,"the fifty shoulder" is called. The disease to strain, sprain, cold as inducement,in the case of medicine "Arthralgia"category. The occurrence of this disease has a serious impact on the daily life of patients with the affected shoulder can not complete the daily activities of dressing, undressing, hair when In serious condition. Clinical treatment is divided into two major categories of conservative therapy and non-conservative treatment. This study focuses on the frozen shoulder in patients with the freezen period, and patients with limited shoulder function as the main characteristics. Treatment based on traditional practices of the disease need a long time and with pain. In this study, combined with the pathogenesis of frozen shoulder, manipulation treatment under the brachial plexus anesthesia is applied.The diagnosis of frozen shoulder is based on clinical symptoms, signs and medical history, and x-ray inspection is mainly used for diagnosis of exclusion. With the development of nuclear magnetic resonance imaging technology, Clear observation of frozen shoulder under MRI,that has gradually been recognized, so MRI is An important means of imaging for studying frozen shoulderStudy objective1The clinical efficacy of brachial plexus anesthesia for manual treatment of frozen shoulder is observed.2Explore the the pathogenesis of shoulder periarthritis and Shoulder situation after manual therapy under brachial plexus anesthesiaResearch method1The periarthritis92patients enrolled in this study, by the path of the interscalene brachial plexus anesthesia, and then held on the sit-pull method, the supine oblique pull and lateral dorsal body pull method for treatment.2weeks after treatment using Yang Shuxuan developed shoulder single activity score(Internal rotation, external rotation, backhand touch back, left/right hand to touch the ear), Shoulder angle total score standards and visual analogue scales to assess the patient’s shoulder range of motion and pain to improve the situation and observe the clinical efficacy of this method of treatment of frozen shoulder.2Six cases of frozen shoulder patients included in the study of the MRI observation,and undergoing routine shoulder oblique sagittal, oblique coronal and axial imaging with T1WI, T2WI and T2WI with fat suppression sequence scanning. Through the T2fat suppressed sequence scanning, observing the thickness of the coracobrachialis ligament, the fat triangle sign under coracoid process,and the groove between the nodules to explore the incidence of frozen shoulder3Under T2WI with fat suppression sequence scanning, Observing the6patients with brachial plexus anesthesia manual therapy if there is bleeding, joint capsule tear, tendon tear, damage of the glenoid lip to learn the anatomical structures of shoulder.Result1Compared with before treatment,two weeks of after treatment joint shoulder single activity score, activity score score increased significantly (t=-50.349, p=0.000); shoulder pain VAS scores decreased significantly (t=24.145, p=0.000); shoulder functional class improved significantly (Z=-8.547,p=0.000); cure rate was13%effective rate of87%, total effective rate was100%.2Included6patients,5cases showed thickening of the coracobrachialis ligament in the shoulder oblique sagittal T2W2fat-suppressed images, and one patient due to take a bit inappropriate, and not found coracobrachialis ligament;6cases of patients with shoulder obliquethe sagittal T2W2fat suppression are found the fat triangle sign under coracoid process; six cases of patients with shoulder in the axial T2W2fat suppression are found abnormal high signal that around the long head of biceps tendon.3After treatment, included6patients on the shoulder axis T2W2fat suppression all have a complete shoulder labrum, showed low signal triangular shape; shoulder oblique coronal T2W2fat suppression images, synovial bursa decline Coracoid had abnormally high signal and the supraspinatus muscle structure integrity, does not appear abnormal high signal abnormal,liquid abnormally high signal signal increased in the shoulder.Conclusion1Manipulation treatment under Brachial plexus anesthesia can improve the functioning of the shoulder effectivly, reduce shoulder pain, its efficacy certainly and is a simple, safe, effective therapy,that is worthy of clinical application. 2Under MRI, the the coracobrachialis ligament thickening is found, that is consistent with previous literature.In addition, the intertubercular groove, and synovial bursa decline the coracoid process have abnormal high signal. This may also be characteristic MRI performance in patient with frozen shoulder3After treatment, under MRI, not found tendon injury, the tear of the labrum, but in the shoulder abnormal high signal increased, its real reason need to be further studied... |
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