Frozen shoulder (FS) is a common shoulder disorder characterized by a gradual increase of pain of spontaneous onset and limitation in range of motion of the glenohumeral joint. The pathophysiology of FS is relatively well understood as a pathological process of synovial inflammation followed by capsular fibrosis, but the cause of FS is still unknown. Treatment modalities for FS include medication, local steroid injection, physiotherapy, hydrodistension, manipulation under anesthesia, arthroscopic capsular release, and open capsular release. Conservative management leads to improvement in most cases. Failure to obtain symptomatic improvement and continued functional disability after 3 to 6 months of conservative treatment are general indications for surgical management. However, there is no consensus as to the most efficacious treatments for this condition. In this review article, we provide an overview of current treatment methods for FS.

Traditionally, adhesive capsulitis (AC) of the shoulder has been regarded as a self-limiting condition without significant long-term sequelae, lasting 18 or 30 months. However, several studies have reported long-term residual motion restriction and persisting symptoms in AC. 1,2) Reeves 1) reported that 50% of patients were still experiencing pain or stiffness of the shoulder at a mean of 7 years from the onset of the condition, although only 11% reported functional limitation. To decrease time to recovery and improve the outcomes, a variety of regimens have been used for the treatment of AC, which include nonsteroidal antiinflammatory drugs, local intra-articular steroid injection, physiotherapy, hydrodilation, manipulation under anesthesia (MUA), and arthroscopic capsular release (ACR). [3][4][5][6][7][8] Among these regimens, MUA has been the longstanding treatment for refractory AC. Numerous studies have reported this approach as a safe and effective treatment for reducing the duration of symptoms in patients with AC 3,6,[9][10][11][12][13][14][15] ; however, others have stated that MUA has no advantages compared with conservative treatment. [16][17][18] Also, the potential complications associated with this

The purpose of this study was to investigate the incidence and risk factors of early postoperative stiffness in patients without preoperative stiffness undergoing isolated arthroscopic rotator cuff repair (ARCR). Two hundred seventy-four patients who underwent primary ARCR were included. At 3 months after surgery, criteria for shoulder stiffness was set as follows: (1) passive forward flexion < 120˚, or (2) external rotation at side < 30˚. Patients with preoperative stiffness or who underwent additional procedures were excluded. Patients-related, radiological (muscle atrophy and fatty infiltration), and intraoperative (tear size, repair techniques, number of anchors used, and synovitis scores) risk factors were analyzed. Univariate and multivariate analyses were used to identify risk factors for postoperative stiffness. Thirty-nine of 274 patients (14.2%) who underwent ARCR developed postoperative stiffness. Univariate analyses revealed that early postoperative stiffness was significantly associated with diabetes mellitus (p = 0.030). However, radiological and intraoperative factors did not affect postoperative shoulder stiffness (all p > 0.05). Multivariate analyses revealed early postoperative stiffness was significantly associated with diabetes mellitus and timing of rehabilitation (p = 0.024, p = 0.033, respectively). The overall incidence of early postoperative stiffness following isolated ARCR in patients without preoperative stiffness was 14.2%. Diabetes mellitus and timing of rehabilitation were independent risk factors for early postoperative stiffness following ARCR.

Purpose:The purpose of this study was to analyze associated factors of primary radial nerve palsy and to evaluate clinical outcome for its treatment in patients with humerus shaft fracture. Materials and Methods: We divided two groups of patients with (17 patients) and without (116 patients) primary radial nerve palsy and analyzed correlation between radial nerve injury and various parameters, including age, sex, cause of injury, AO classification, fracture type, fracture location, and presence of open fracture. We also evaluated configuration of nerve injury, presence of recovery, and recovery time. Results: The overall prevalence of primary radial nerve palsy after humerus shaft fracture was 12.8% (17 palsies in 133 fractures). Younger age, AO type B, and distal 1/3 fractures showed significantly higher correlation with radial nerve palsy. No significant correlation was observed between radial nerve palsy and other parameters, including sex, cause of injury, fracture type, and presence of open fracture. Thirteen patients (76.5%) underwent early nerve exploration with internal fixation. Intraoperatively, all patients had continuity of radial nerve except one patient with segmental loss. At the final follow-up, 16 patients (94.1%) with radial nerve palsy had made a complete recovery. The mean time to complete recovery was 6.7 months. Conclusion: Primary radial nerve palsy after humerus shaft fracture was more common in young age, AO type B, distal 1/3 fractures. Early surgical exploration can be recommended to confirm the condition of the radial nerve if the fracture should be fixed.