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Re: Вращательная манжета
послал Sereda Andrey 05 Апрель 2010, 06:08
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Нет. Адгезивный капсулит и замороженное плечо - более широкое понятие. Это одна из групп "скованного плеча". Тут, конечно, вопрос дискутабельный, и каждый автор вкладывает немного своего смысла.
Но, например Роквуд (4-е издание) все скованные плечи делит на первичные и идиопатические, что как раз и есть замороженное плечо и на приобретенные (посттравматические и постоперационные).
Впрочем что я Роквуда пересказываю
DIAGNOSTIC CRITERIA
Idiopathic frozen shoulder implies a global glenohumeral capsular contracture that occurs in the absence of a definable traumatic event. Acquired stiffness is an extrinsic process related to some other, often traumatic, cause. These conditions might not be mutually exclusive. On rare occasions, inflammation and adhesions have been identified in the subacromial bursa in association with idiopathic frozen shoulder.[20] Although acquired stiffness is generally the result of an extracapsular process, subsequent capsular contracture can develop.
Idiopathic Frozen Shoulder
The lack of consensus regarding nomenclature and classification for frozen shoulder has in part originated from the confusion surrounding the necessary and sufficient diagnostic criteria. Many authors, however, have proposed diagnostic criteria for frozen shoulder. Considerations include patient history, relative loss of motion in various planes, motion loss compared to the contralateral shoulder, and radiographic findings.
We do not subscribe to a specific, published set of criteria, but we do consider certain characteristics to be key components in the diagnosis of a frozen shoulder. These include a lack of history of major trauma or surgery about the shoulder, significantly limited passive and active ROM in all planes compared to the contralateral shoulder, and normal radiographs or other advanced imaging studies.
Acquired Shoulder Stiffness
The earliest description of shoulder stiffness occurring after trauma was recorded in 1859 by Malgaigne, who wrote with regard to minor nondisplaced extracapsular fractures about the shoulder[1]:
There remains long afterward a stiffness, and a difficulty in moving the shoulder; and however great care may be taken, the motion of elevation of the arm will always remain limited; at least I have in no case seen it perfectly restored, even after the lapse of from eleven to fifteen months.
Less controversy and confusion surround the nomenclature of this clinical entity. Other commonly used terms for the same condition include post-traumatic stiff shoulder and secondary stiffness. It is unclear whether acquired stiffness recovers without intervention. This is difficult to study because of the heterogeneity of this patient population.
Some degree of shoulder stiffness is typical after bone or soft tissue injuries around the shoulder. Restriction in shoulder motion has been reported after simple contusions, subluxations, dislocations, acromioclavicular joint injuries, clavicle and scapula fractures, and especially after proximal fractures of the humerus in the elderly.[63,64]
Localized contractures can develop, usually after repetitive, low-level trauma, and can cause motion loss in specific patterns. Isolated posterior capsular contracture is the most commonly described. Neer discussed the impingement syndrome and encouraged therapeutic stretching in forward elevation, internal rotation, and cross-body adduction.[65] Thomas[66] and Ticker[25] have made similar recommendations. In a review of 30 patients from a prospective study of refractory shoulder stiffness, 11 experienced isolated restriction in motion that was attributed to posterior capsular contracture.[21] In each of these patients, an associated pathologic process was identified; in 7 cases, a partial-thickness rotator cuff tear was the pathology.
Surgical procedures are widely recognized as a cause of shoulder stiffness. Anterior or posterior capsulorrhaphy, inferior capsular shift, and rotator cuff surgery can all result in limitation of motion, often by design. Tauro found a relatively high incidence of stiffness in patients undergoing surgery for a rotator cuff tear. Patients with more pronounced stiffness often had difficulty regaining normal motion after surgery.[67]
Если у вас его нет - погуглите, он на файлообменниках и на торрентах встречается.
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