Hydraulic expansion means a small knife with releasing the clinical observation of

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To evaluate the hydraulic expansion means a small knife with releasing the clinical effect of treatment of frozen shoulder. [Method] 37 patients treated by means of hydraulic expansion of a small knife with releasing treatment, control group 29 cases, the use of small knife with manipulation LOOSE. [Results] The cure rate was significantly higher overall response rate (P <0.05, treatment was significantly shorter than the control group (P <0.01, significantly higher than improved the next day (P <0.05. [Conclusion] The hydraulic expansion means a small knife with releasing the effective treatment of frozen shoulder.
[Keywords:] shoulder, hydraulic expansion, release techniques, small knife, treatment

Abstract: [Objective] To evaluate the clinical effect of hydraulic distension manipulation release with small needle knife in the treatment of scapulohumera periarthritis. [Method] The treatment group 37 cases, treated with hydraulic distension manipulation release and small needle knife. The control one 29 cases, with small needle knife and manipulation release. [Result] The cure rate and total effective rate for the treatment group were better than control one. The course of the treatment group was observably shorter, and the second day's improvement rate was better than that of control one. [Conclusion] The method to the treatment group is very effective.

Keywords:: scapulohumeral periarthritis; hydraulic distension; manipulation release; small needle knife; therapeutic outcomes

Periarthritis of the shoulder periarthritis, also known as "frozen shoulder", "frozen shoulder" is due to the shoulder joint and soft tissue lesions caused by pain and dysfunction of the shoulder joint. By hydraulic expansion of our hospital with releasing small needle technique Comprehensive treatment of frozen shoulder blade achieved satisfactory clinical results.

1 Materials and Methods

1.1 General Information
Of July 2006 to June 2008 in our hospital, 66 patients with unilateral frozen shoulder were treated with randomized control approach, the treatment group 37 cases, including 15 males and 22 females, 20 cases of left shoulder, right shoulder 17 patients, aged 34 to 71 years, mean 51 years, duration of 1 to 36 months. the control group 29 cases, including 13 males and 16 females, 18 cases of left shoulder, right shoulder in 11 cases, aged 32 to 78 years, mean 53 years of age, duration of 1 to 36 months. group sex, age, duration no significant difference compared (P> 0.05.

1.2 Diagnostic criteria
shoulder pain, particularly at night night, shoulder limited mobility, flexion on the move less than 90 degrees, less than 45 degrees abduction, extension and touch the waist is less than 25 degrees, increase the passive range of severe pain, widespread tenderness around the shoulder joint, such as the brachial two tendon, deltoid, coracoid process, acromion, the humeral large and small nodules, supraspinatus, infraspinatus muscle, subscapular angle, the medial margin of scapula, etc., X-ray films and more no obvious abnormalities, except for fracture, dislocation, cervical spondylosis, cuff tendon injury and other causes of shoulder pain.

1.3 Treatment
1.3.1 group
Routine preoperative coagulation function, blood glucose, shoulder plain film examination, coagulation dysfunction, hyperglycemia (fasting glucose greater than 8mmol, severe osteoporosis, were banned. Intraoperative brachial plexus block anesthesia are used, after the success of anesthesia strict aseptic operation, suffering from shoulder and regular disinfection of shop towels, supine patients suffering from mild shoulder external rotation, external rotation, with 7 small needle in the shoulder in front of the humerus and the coracoid process nodes into the joint cavity between the vertical needle, puncture After the success of the syringe with 50ml 30 ~ 50ml injection of slow expansion of fluid (triamcinolone acetonide 10mg, 2% lidocaine 5ml, NS 25 ~ 45ml, to a considerable resistance after intra-articular pull out the needle, sterile dressing over the puncture point .

then given to patients suffering from passive shoulder adduction, abduction, internal rotation, external rotation, flexion, extension, uplift and other activities, and to massage the muscles around the shoulder joint, release. way to be slow continuous force, the impact of violence taboo , from light to heavy, repeated several times until the shoulder joint approach or reach the normal range. after fracture and dislocation X film review excluded the first 2 days evaluated, and then guiding the shoulder in patients suffering from active functional exercise, functional training to patients feel for the degree of pain but it can tolerate, each movement 20 times each, 4 times / d, exercise every day during treatment. The first 7 days, 1 small knife treatment (control group, the specific method, the general 7d as a course of treatment, 8 cases in which treatment 14d, 14 days plus a small needle knife 1, followed up for 6 months, evaluated.

1.3.2 the control group
Patients were sitting, the first to find tender points, with crystal violet syrup to mark the point tenderness, local anesthesia after the mark, parallel to the vertical edge line and the tendon piercing, the first cut for the longitudinal strip, and then clear the strip longitudinal , stripping knife-edge as close to the bone surface when the amplitude not too much. incision bandage with Band-Aid. small knife after the patient was supine, the shoulder immediately to give patients suffering from the same practices can not release until the limb reaches the maximum when to cite to patients can tolerate for the degree. after 2 days as evaluated, guiding the same shoulder in patients with active functional exercise. a small knife treatment three times, each time interval of 7d, 14d is a course of treatment, followed up for 6 months, evaluated.

2 Results
2.1 Clinical Standards
Issued in 1994 <<Chinese disease diagnosis and efficacy of the standard>> standard [1] the efficacy of standard combination of Liu Jijun, etc. [2]: healing: shoulder pain, shoulder function recovered completely or, shoulder abduction of 90 degrees, dual-arm elbow extension on the move, the affected side difference in finger height and the healthy side was 0 cm, touch the back extension and internal rotation, the second metacarpal bone above the level reached T10 spinous process. improved: shoulder pain relief, improved mobility , greater than 75 degrees abduction, elbow extension on the upper limbs move, the affected side and normal side difference in finger height of less than 5cm, touch the back extension and internal rotation, the second metacarpal bone reach above the level of L2 spinous process. healed: no significant improvement in symptoms after treatment.

2.2 Treatment Results
Two groups of patients were followed up for 6 months after the effective course of treatment, improvement rate between day 2 in Table 1, Table 2. Table 1 Comparison of efficacy of two groups of patients (slightly Note: Compared with control group, * P <0.05 Table 2 two patients course of treatment, improvement rate between day 2 (slightly

3 Discussion
[1], Frozen shoulder usually involves multiple inflammatory synovial effusion, adhesions, in which common clinical subacromial bursa, deltoid bursa and shoulder joint cavity is not the same, so the hydraulic expansion therapy on the shoulder outside the synovial cavity adhesion and can not play the role of expansion and release. Meanwhile, the shoulder joint cavity to the axillary recess and the adhesion of contracture of the long head biceps tendon sheath of the most obvious and common

[2], where the narrow long head biceps hydraulic expansion of tendon bursa is the most difficult part of the expansion, but also affect functional recovery after treatment, an important factor in the shoulder joint

[3]. In addition, the frozen section in patients with adhesions not only about the same time, there is also a wide range of soft tissue around the joints without bacterial inflammation, exudation, adhesion. hydraulic expansion means after the release of hydraulic expansion not only to open but not completely separate organization to be more complete separation of adhesions, but also around the shoulder joint can be separated from the bursa and soft tissue adhesions, thus further improve shoulder function. a small knife treatment on the one hand directly on the inside and outside the joint capsule and the hydraulic expansion means is not easy to achieve release of the lesion site, directly and thoroughly to the bone surface tendons, ligaments and other adhesion action open, not only cut lesions , release of soft tissue adhesions and restore joint function, but also the compression of the nerves and blood vessels get loose and restore normal nerve conduction, the establishment of blood return path, take away the pain caused by a large number of substances, so that improvement in tissue hypoxia, has also been effective pain relief, shoulder mobility has been further to the recovery.

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