Donmuş omuz hastalığının tedavisinde artroskopik kapsüler gevşetme
Amac: Bu çalışmada, donmuş omuz hastalıgında glenohumeral eklemin artroskopik gevşetmesinin teknik yönleri ve sonucları degerlendirildi. Çalışma planı: Yakınmalar fizik tedaviyle düzelmeyen 16 hastaya (11 kadın, 5 erkek; ort. yaş 51; dağılım 40-60) artroskopik kapsüler gevşetme uygulandı. On iki hastada (%75) dominant taraf olmak üzere, 10 hastada sağ, altı hastada sol omuz tutulumu vardık. Ameliyat öncesi şikayet süreleri 6 ile 24 ay arasında degişmekteydi. Hastaların ameliyat oncesi ortalama one fleksiyonu 92 derece, dış rotasyonu 14 derece idi; iç rotasyon ise dört hastada trokanter seviyesinde, yedi hastada gluteal, bir hastada lumbosakral, bir hastada L3, üç hastada T12 seviyesinde bulundu. Omuz fonksiyonlan Constant omuz skorlama sistemine göre degerlendirildi. Ortalama izlem süresi 17.3 ay (dagilim 12-30 ay) idi. Sonuçlar: Ameliyat sonrası dönemde ortalama one fleksiyon 135 derece, dış rotasyon 27 derece; iç rotasyon iki hastada gluteal, iki hastada lumbosakral, iki hastada L3, dokuz hastada T12, bir hastada interskapular seviyede bulundu. Constant skorunda ortalama 47 puanlık artış sağlandı. Çıkarımlar: Konservatif tedaviyle düzelmeyen donmuş omuzlu olgularda artroskopik kapsüler gevşetmenin güvenli ve etkili bir tedavi yöntemi olduğunu düşünüyoruz.
Arthroscopic capsular release for frozen shoulder
Objectives: This study was designed to evaluate the results and technical considerations of arthroscopic capsular release of the glenohumeral joint in frozen shoulder disease. Methods: Arthroscopic capsular release was performed in 16 patients (11 women, 5 men; mean age 51 years; range 40 to 60 years) unresponsive to physical therapy. The affected shoulder was on the right in 10 patients, and on the left in six, being on the dominant side in 12 patients. The duration of the patients' complaints ranged from six to 24 months. Preoperatively, the mean forward flexion was 92 degrees, external rotation was 14 degrees; the ranges of internal rotation were the trochanter in four patients, the gluteal region in seven patients, the lumbosacral region in one patient, the L3 level in one patient, and T12 level in three patients. Functional evaluations were made according to the Constant scoring system. The mean follow-up was 17.3 months (range 12 to 30 months). Results: Postoperatively, the mean forward flexion and external rotation increased to 135 and 27 degrees, respectively. Internal rotation reached the gluteal region in two patients, the lumbosacral region in two patients, the L3 level in two patients, T12 level in nine patients, and the interscapular region in one patient. The mean Constant score improved by 47 points. Conclusion: Arthroscopic capsular release is a safe and effective surgical procedure in the management of frozen shoulder disease unresponsive to conservative treatment.
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