'Catfish effect' theory in the needle-knife treatment of frozen shoulder

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will 'catfish effect' philosophy applied to needle-knife therapy for frozen shoulder. Protest lysis beak ligament is a needle-knife treatment of frozen shoulder brachial important part.
[Keywords:] scapulohumeral periarthritis; needle-knife therapy; Catfish Effect
Frozen shoulder frozen shoulder is a common type, commonly referred to as frozen shoulder, more likely than referring to the frozen shoulder. Frozen shoulder with rapid onset, severe pain, shoulder muscle protective spasm, caused by the activities of limited shoulder. The acute phase generally lasted 2 to 3 weeks after the chronic phase to enter.
1 'catfish effect' theory in the use of frozen shoulder treatment
Needle-knife therapy is currently in the efficacy of conservative treatment of frozen shoulder sure that a shorter course of treatment, patients more acceptable method of treatment. Treatment typically begins with the needle-knife to find the most obvious point of tenderness, but a lot of history longer or more severe in patients with adhesions are often not very clear, tender points, the chief complaint often only 'pain in the shoulder and upper arm are not out of pain, but the inside pain, hard to explain specifically what point, shoulder limited activity '. At this time we will be based on clinical experience, for the first time prior to the brachial beak ligament, coracoid Department, supraspinatus arrived only side gang under the teres minor muscle and the arrival only for the treatment of end-point, the general election 2 to 3 points, rostral brachial ligament which must be selected for the point, because it is the author use the word 'catfish effect' of the catfish.
2 treatment
 Patient sitting or lateral position, the skin has fully exposed the ipsilateral shoulder, gentian violet points, or experience pain in the sensitive treatment of fixed points, local disinfection, shop-hole towel, mixed imitation Stejneger's solution (2% lidocaine 5ml, vitamin B122mg, indeed triamcinolone acetonide 20mg, normal saline 10ml), half of mixture into the shoulder joint cavity, and the other half of mixture were injected into each treatment point, the medical Shi pressurized piercing needle-knife technique, needle-knife to reach lesions after incision with dissection or vertical line to clear the stripping method, peel 3 ~ 5-pin, when the needle under the pine needles out of dynamism, when the last band-aid deposited cover.
7d treatment every 1, 3 ~ 5 times for a course of treatment, most patients can be fundamental cure for a course of treatment. The vast majority of patients after the first needle-knife therapy after consciously ipsilateral Jianbi pain better, suffering from shoulder and activity improved. The most important is that the patient was separated 7d hospital for the second treatment can be very clearly pointed out that often the most obvious point of tenderness, pain points, these points with needle-knife as a treatment for lysis, supported by appropriate means traction pull stretch rotation in order to restore the activity of the shoulder joint. Are often subject to a second needle knife, after lysis, the patient will be significant improvement in symptoms, suffering from shoulder activity also improved significantly. Later according to the severity of illness, need a ~ 3 times a needle knife loosen, leak fill a vacancy, the consolidation of efficacy, a course of treatment usually no more than 5 times.
3 experience
Author in clinical profoundly aware that lysis beak ligament is a needle-knife treatment of frozen shoulder brachial important part. Brachial beak ligament is a tough fiber bundles, affixed to the top of the shoulder joint capsule, starting at the outer edge of the Ministry of coracoid process level, down through the supraspinatus and the subscapularis muscle between its fibers to the joint capsule and with the large, small nodules between the transverse humeral ligament connects the proximal fiber spin out when the tension, there are bound shoulder external rotation role. Humeral adduction internal rotation when the beak ligament and joint capsule of brachial beak squeezed in between the gap, resulting in varying degrees of compression shocks and friction, combined with multi-axis position of the shoulder joint activities so that the organization of chronic wear and tear of rotator cuff, shoulder bag degeneration, leading to shoulder around the muscles, ligaments adhesion, particularly adhesion rostral brachial ligament shortening, in varying degrees, the activities of limited shoulder.
Therefore, treatment of frozen shoulder contracture should first be denatured lysis beak to beak brachial brachial ligament gap increases. Needle-knife operation in the coracoid process to clear the lateral longitudinal spin-off, if the beak ligament degeneration of brachial sclerosis, needle under which there is a clear sense of resistance, this time knife-edge lines can be turned 90 degrees, so that the blade with the beak ligament fibers perpendicular to the brachial, top-down followed by cutting, rampant shovel stripping, needle under the loose change is better. Reason refractory frozen shoulder, in fact, because the disease more than the Department of bursa lesions, lesions involving the glenohumeral joint articular capsule, subacromial, or deltoid, the long head biceps tendon bursa, etc.. Early lesions of bursa hyperemia, edema and exudation synovial cavity adhesions post-lockout, fiber-like change. Shoulder pain affected the early events involved in the above inter-organizational development of fibrosis and scar further restrict the activities of the shoulder.
This vicious cycle, causing an objective to extend the course of the disease, adding to the suffering of patients, while the extension of course, exercise pain, short-term cure in patients with remote has led to subjective doctors were unwilling to cooperate actively in functional training, thus greatly reducing the In the hospital physical therapy and oral anti-inflammatory analgesic efficacy, a further blow to the confidence of patients, leading to further vicious circle. Lysis beak as if the entire brachial ligament treatment of frozen shoulder into a 'catfish', after this 'catfish' stimulus, making up the entire treatment interaction, treatment improved the symptoms, functional exercises makes it possible through functional exercises make deep surface of the lesion and the surface adhesion points, giving the direction of the medical treatment, by further treatment, but also to further improve the symptoms and activity.

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