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Vol. 161 No. 9, June 30, 1956 |
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ARTICLES |
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TREATMENT OF CHECKREIN SHOULDER BY USE OF MANIPULATION AND CORTISONE
Thomas B. Quigley, M.D.
J Am Med Assoc. 1956;161(9):850-854.
Abstract
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Checkrein shoulder is distinguished from other types of "frozen shoulder" by a history, in a middleaged person, of disuse that may or may not have followed an initiating event, by slow return of joint mobility limited to the lower ranges with a painful check to the upper ranges of motion, by resistance to ordinary treatment, by findings of limited passive abduction and rotation, by x-ray findings of demineralization from disuse with calcification deposits in 20%, and by a palpable and audible release of resistance during manipulation under anesthesia.
Of 44 checkrein shoulders so manipulated, 33 promptly regained a normal range of motion if the postmanipulation pain was suppressed by orally given cortisone, parenterally given corticotropin, and/or locally injected hydrocortisone acetate and hyaluronidase. In 11 cases, improvement was achieved but some pain or limitation remained. Six cases of frozen shoulder that did not satisfy the above diagnostic criteria were not improved. Since manipulation has in one of these resulted in fracture of the anatomic neck of the humerus, it must be done with care.
Author Affiliations
Boston
Assistant Clinical Professor in Surgery, Harvard Medical School, and Senior Associate in Surgery, Peter Bent Brigham Hospital.
Footnotes
Figure 1 is reproduced with permission from Neviaser9b and figures 2A and 3 and case 1 from Quigley.2b
Read before the Ninth Clinical Meeting of the American Medical Association, Boston, Nov. 29, 1955.
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