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ARTICLE |

MANAGEMENT OF THE "FROZEN" SHOULDER FREE

G. Edmund Haggart, M.D.; Thomas S. Sullivan, M.D.
[+] Author Affiliations

Read before the Ninth Clinical Meeting of the American Medical Association, Boston, Nov. 29, 1955.


Boston

From the Department of Orthopedic Surgery, Lahey Clinic.


JAMA. 1956;161(13):1219-1222. doi:10.1001/jama.1956.02970130007002
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• Immobility of the articulatio humeri sets in most frequently in middle life. It is usually ascribed to some minor trauma, but in reality the cause and exact nature of the derangement are both in doubt.

The treatment recommended here consists of hospitalization, closely supervised therapeutic exercise, and manipulation of the joint at several sessions with the patient under general anesthesia. Complete mobilization must not be expected at the first session but is achieved in stages. The exercise program continues during the intervals of three to five days between manipulations.

Ninety-six patients who had been treated for "frozen" shoulder in this way responded later to a detailed questionnaire and also returned for a physical examination. The results of the treatment were thus evaluated by both subjective and objective criteria. Open operation alone can yield the explanation of this condition, but the closed method here advocated gave results classified as good to excellent by objective as well as subjective criteria, and it was not followed by complications in any case.

REFERENCES

Codman, E. A.: The Shoulder , Boston, Thomas Todd and Co., 1914;.
McLaughlin, H. L., and Asherman, E. G.:  Lesions of Musculotendinous Cuff of Shoulder: Some Observations Based upon Results of Surgical Repair , J. Bone & Joint Surg. 33-A: 76-86 ( (Jan.) ) 1951;.
McLaughlin, H. L.:  On "Frozen" Shoulder , Bull. Hosp. Joint Dis. 12:383-393 ( (Oct.) ) 1951;.
Lippmann, R. K.:  Frozen Shoulder: Periarthritis: Bicipital Tenosynovitis , Arch. Surg. 47: 283-296 ( (Sept.) ) 1943;.
Neviaser, J. S.:  Adhesive Capsulitis of Shouulder: Study of Pathological findings in Periarthritis of Shoulder , J. Bone & Joint Surg. 27: 211-222 ( (April) ) 1945;.
Quigley, T. B.:  Checkrein Shoulder: A Type of "Frozen" Shoulder: Diagnosis and Treatment by Manipulation and ACTH or Cortisone , New England J. Med. 250: 188-192 ( (Feb. 4) ) 1954;.
Bosworth, D.:  An Analysis of 28 Consecutive Cases of Incapacitating Shoulder Lesions, Radically Explored and Repaired , J. Bone & Joint Surg. 22: 369-392 ( (April) ) 1940;.
Fowler, E. B.:  Stiff, Painful Shoulders, Exclusive of Tuberculosis and Other Infections , J. A. M. A. 101:2106-2109 ( (Dec. 30) ) 1933;.
Simmonds, F. A.:  Shoulder Pain, with Particular Reference to "Frozen" Shoulder , J. Bone & Joint Surg. 31-B: 426-432 ( (Aug.) ) 1949;.
DePalma, A. F.; Gallery, C., and Bennet, C.:  Anatomy and Degenerative Lesions of the Shoulder Joint , in Academy of Orthopedic Surgeons Instructional Course Lectures , vol. 6, Blount, W. P., and Banks, S. W., editors, Ann Arbor, Mich., J. W. Edwards, 1949;, chap. 6, pp. 255-280.
Codman, E. A.:  On Stiff and Painful Shoulders: The Anatomy of the Subdeltoid Subacromial Bursa and Its Clinical Importance: Subdeltoid Bursitis , Boston Med. & Surg. J. 154: 613-620, 1906;.
Putnam, J. J.:  The Treatment of a Form of Painful Periarthritis of the Shoulder , Boston Med. & Surg. J. 107: 536-539 ( (Dec. 7) ) 1882;.
Lapidus, P. W.:  Infiltration Therapy of Acute Tendinitis with Calcification , Surg. Gynec. & Obst. 76:715-725 ( (June) ) 1943;.
Inman, V. T.; Saunders, J. B. deC. M., and Abbott, L. C.:  Observations on Function of Shoulder Joint , J. Bone & Joint Surg. 26: 1-30 ( (Jan.) ) 1944;.
Haggart, G. E., and Carr, C. R.:  Chronic Adhesive Subacromial Bursitis , New England J. Med. 229:987-996 ( (Dec. 30) ) 1943;.
McGregor, L.:  Rotation at Shoulder: Critical Inquiry , Brit. J. Surg. 24:425-438 ( (Jan.) ) 1937;.
Milowsky, J., and Rovenstine, E. A.:  Suprascapular Nerve Block: Evaluation in Therapy of Shoulder Pain , Anesthesiology 10: 76-81 ( (Jan.) ) 1949;.
Gardner, E.:  Innervation of Shoulder Joint , Anat. Rec. 102: 1-18 ( (Sept.) ) 1948;.

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Codman, E. A.: The Shoulder , Boston, Thomas Todd and Co., 1914;.
McLaughlin, H. L., and Asherman, E. G.:  Lesions of Musculotendinous Cuff of Shoulder: Some Observations Based upon Results of Surgical Repair , J. Bone & Joint Surg. 33-A: 76-86 ( (Jan.) ) 1951;.
McLaughlin, H. L.:  On "Frozen" Shoulder , Bull. Hosp. Joint Dis. 12:383-393 ( (Oct.) ) 1951;.
Lippmann, R. K.:  Frozen Shoulder: Periarthritis: Bicipital Tenosynovitis , Arch. Surg. 47: 283-296 ( (Sept.) ) 1943;.
Neviaser, J. S.:  Adhesive Capsulitis of Shouulder: Study of Pathological findings in Periarthritis of Shoulder , J. Bone & Joint Surg. 27: 211-222 ( (April) ) 1945;.
Quigley, T. B.:  Checkrein Shoulder: A Type of "Frozen" Shoulder: Diagnosis and Treatment by Manipulation and ACTH or Cortisone , New England J. Med. 250: 188-192 ( (Feb. 4) ) 1954;.
Bosworth, D.:  An Analysis of 28 Consecutive Cases of Incapacitating Shoulder Lesions, Radically Explored and Repaired , J. Bone & Joint Surg. 22: 369-392 ( (April) ) 1940;.
Fowler, E. B.:  Stiff, Painful Shoulders, Exclusive of Tuberculosis and Other Infections , J. A. M. A. 101:2106-2109 ( (Dec. 30) ) 1933;.
Simmonds, F. A.:  Shoulder Pain, with Particular Reference to "Frozen" Shoulder , J. Bone & Joint Surg. 31-B: 426-432 ( (Aug.) ) 1949;.
DePalma, A. F.; Gallery, C., and Bennet, C.:  Anatomy and Degenerative Lesions of the Shoulder Joint , in Academy of Orthopedic Surgeons Instructional Course Lectures , vol. 6, Blount, W. P., and Banks, S. W., editors, Ann Arbor, Mich., J. W. Edwards, 1949;, chap. 6, pp. 255-280.
Codman, E. A.:  On Stiff and Painful Shoulders: The Anatomy of the Subdeltoid Subacromial Bursa and Its Clinical Importance: Subdeltoid Bursitis , Boston Med. & Surg. J. 154: 613-620, 1906;.
Putnam, J. J.:  The Treatment of a Form of Painful Periarthritis of the Shoulder , Boston Med. & Surg. J. 107: 536-539 ( (Dec. 7) ) 1882;.
Lapidus, P. W.:  Infiltration Therapy of Acute Tendinitis with Calcification , Surg. Gynec. & Obst. 76:715-725 ( (June) ) 1943;.
Inman, V. T.; Saunders, J. B. deC. M., and Abbott, L. C.:  Observations on Function of Shoulder Joint , J. Bone & Joint Surg. 26: 1-30 ( (Jan.) ) 1944;.
Haggart, G. E., and Carr, C. R.:  Chronic Adhesive Subacromial Bursitis , New England J. Med. 229:987-996 ( (Dec. 30) ) 1943;.
McGregor, L.:  Rotation at Shoulder: Critical Inquiry , Brit. J. Surg. 24:425-438 ( (Jan.) ) 1937;.
Milowsky, J., and Rovenstine, E. A.:  Suprascapular Nerve Block: Evaluation in Therapy of Shoulder Pain , Anesthesiology 10: 76-81 ( (Jan.) ) 1949;.
Gardner, E.:  Innervation of Shoulder Joint , Anat. Rec. 102: 1-18 ( (Sept.) ) 1948;.
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