Background: In 1934, Codman¹ described the clinical picture of adhesive capsulitis with gradual onset of lateral shoulder pain with limitation of active and passive movement. Adhesive capsulitis is a common but poorly understood cause of painful dysfunction of shoulder affecting activities of daily living. Many treatment modalities are available for adhesive capsulitis but there is no definitive evidence of superiority of available procedures one over the other. Aim: To evaluate functional outcome in adhesive capsulitis of shoulder treated by hydrodilatation and intraarticular steroid injection. Materials and Methods: A series of 42 patients of adhesive capsulitis between age group 40-70years attended Pgi Swasthiyog Prathisthan, Miraj between June 2020 to June 2022 were included in this study.All patients were treated with hydrodilatation under fluoroscopy with intraarticular steroid injection with subacromial and ac joint injection. All patients were evaluated for functional improvement by oxford shoulder score with a minimum follow up 3 months with a maximum followup of 1 year. Mean age group was 56.66. Inclusion criteria: All patients with painful restriction of active and passive shoulder mobilization Exclusion criteria: Post infective shoulder stiffness, rotator cuff tear, previous fracture of proximal humerus, shoulder arthritis. Results -All patients were assessed by oxford shoulder score pre and post procedure. All patients regained total to near total shoulder movements by end of 1 month. There was decrease in oxford shoulder score by mean of 20.2 (pre-operative was 32.42 and postoperative was 12.22). Conclusion: Fluoroscopic hydration with intra-articular steroid injections can be used as a definitive treatment for patients with adhesive capsulitis. This results in significant pain relief and also provides interphase recovery with near-to-full range of motion in the shoulder.
Background: Intertrochanteric fracture (ITF) is a major part of fracture in femur. 95% of ITF are found in elderly patients. Osteosynthese is the preferred method of choice. However, elderly patients had osteoporotic, combined with many of chronic disease conditions that increase the rate of osteosynthese failure. Hemiarthroplasty bipolar long-stem is a surgical method that helps patients relieve pain, facilitate early rehabilitation, limit long-term complications, and improve quality of life for patients. Aim: The aim of our study is to evaluate the clinical of the result of primary cementless bipolar long stem hemiarthroplasty in treatment for unstable ITF in the elderly patients. Methods: We retrospectively analyzed 35 cases of primary hemiarthroplasty performed for osteoporotic unstable intertrochanteric fractures (AO/OTA type 31-A2.2 and 31-A2.3 and Evans type III or IV fractures). There were 26 females and 9 males with a mean age of 77.1 years (range, 62-89 years). Results: Mean age of studied subjects was 84.29 ± 6.17, the lowest was 71, the highest was 96; ratio of male/female was 1:288. Follow-up of 33 patients for at least 6 months showed 88.6% caused by a lowenergy injury; Average rehabilitation time was 4.63 ± 1.7 days. The average Harris point at the end was 90.4 ± 4.72. Conclusion: Primary cementless bipolar long stem hemiarthroplasty is one of good choices in treatment of unstable ITF in elderly patients with severe osteoporosis, helped patients improve the quality of life.
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