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J Pak Med Assoc. 2007 Apr;57(4):181-5.

Functional outcome of frozen shoulder after manipulation under anaesthesia.

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Departments of Orthopedics, Abbasi Shaheed Hospital, Karachi.



To analyze and compare the functional outcome in adhesive capsulitis after manipulation under anaesthesia and keeping the extremity in abduction and external rotation combined with local steroid injection v/s manipulation under anaesthesia combined with local steroid alone, in terms of range of motion.


A comparative prospective study was done at the department of Orthopedics Surgery, Liaquat National Hospital, Karachi. A total of 33 patients with adhesive capsulitis of shoulder joint were included and divided into 2 groups. Group 1 (n-16) underwent manipulation under anaesthesia and manipulated extremity was kept in abduction and external rotation combined with local steroid injection. In Group 2 (n-17) patients also underwent manipulations under general anaesthesia with local steroid injection alone. After manipulation both groups had daily physiotherapy session for half an hour.


After manipulation, in both groups there was a significant increase in global'range of motions of the shoulder joint. However, the group 1 patients demonstrated more increase in all range of motion as compared to group 2. The result showed significant improvement in all range of movements except external rotation and forward flexion.


After manipulation, simply tying the manipulated extremity to the back of bed greatly influences regaining the range of motions with no additional cost. These patients need counseling and motivation for their active participation in physical therapy program even after manipulation for optimal long term result.

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