Resultados de la artrólisis artroscópica en hombro rígido postraumático

Objective

To evaluate the functional results of arthroscopic shoulder arthrolysis for the treatment of the shoulder stiffness due to conservatively treated proximal humeral fractures.

Material and methods

Retrospective study of 9 patients with shoulder stiffness after suffering a proximal humerus fracture despite at least six months of rehabilitation treatment without satisfactory outcomes. An arthroscopic shoulder arthrolysis was performed on all of them, working on both the glenohumeral and subacromial-deltoid spaces. The passive range of motion, pain scale, with a simple numerical scale of 0-10, and functioning with the Constant test, were evaluated before surgery and at the end of the follow-up period.

Results

After a 12-month (standard deviation: 1.5) follow-up, there was a significantly increase in the Constant test values from 37.6 (19.9) to 74.1 (12.8) (p = .004). The shoulder overall range of motion increased significantly from 213° (84.1°) to 377° (53.6°) (p<0.001); with improvements in all ranges of motion: arm flexion from 91.7° (37.1°) to 146° (19.0°) (p = .001); abduction from 88.3° (40°) to 132° (15.8°) (p = .003); external rotation from 14.4° (5.27°) to 50° (14.1°) (p = .0001), and internal rotation from 18.9° (11.7°) to 48.9° (12.7°) (p = .0003). The vertebral level achieved with the hand behind back improved from S1 to T11. The simple numerical scale decreased from 5.33 (3.24) to 1.33 (2.06) (p = .006).

Conclusion

Arthroscopic arthrolysis is effective in decreasing pain, increasing the range of motion, and improving function in the post-traumatic stiff shoulder.

Level of evidence

Level IV.