Capsulitis adhesiva del hombro. Comparación entre métodos de tratamiento conservador

• Joao Artur Bonadiman ^[1] ; Nelson Esteve ^[1] ; Felipe Ramiro Triervelier Paiva ^[1] ; Paulo C. Faiad Piluski ^[1] ; Carlos Humberto Castillo Rodriguez ^[1] ; Osvandré Lech ^[1]
  1. [1] Hospital São Vicente de Paulo

     Hospital São Vicente de Paulo

     Brasil

     
• Localización: Revista de la Asociación Argentina de Ortopedia y Traumatología, ISSN 1852-7434, Vol. 87, Nº. 6, 2022, págs. 781-788
• Idioma: español
• DOI: 10.15417/issn.1852-7434.2022.87.6.1625
• Títulos paralelos:
  • Adhesive Capsulitis of the Shoulder: Comparison Between Conservative Treatment Methods
• Enlaces
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• Resumen
  • español

    Objetivo: Evaluar los resultados funcionales de tres protocolos distintos de tratamiento conservador en pacientes con capsulitis adhesiva del hombro.

    Materiales y Métodos: Se revisaron las historias clínicas de los pacientes tratados por capsulitis adhesiva en nuestra institución, entre enero de 2016 y enero de 2019. Se compararon tres protocolos diferentes de tratamiento: grupo 1, bloqueo del nervio supraescapular con un anestésico local y corticoide, analgésicos y fisioterapia después del alivio del dolor; grupo 2, bloqueo del nervio supraescapular con anestésico local sin corticoide, analgésicos y fisioterapia; grupo 3, analgésicos y fisioterapia, sin bloqueo del nervio supraescapular. Se determinaron los resultados funcionales con la escala ASES y el resultado subjetivo con el SSV.

    Resultados: Se dividió en tres grupos a 46 pacientes tratados por capsulitis adhesiva. Los pacientes del grupo 3 tuvieron, en promedio, más sesiones de fisioterapia (30,31 ± 21,07). Los del grupo 2 recibieron la mayor cantidad promedio de bloqueos del nervio supraescapular (3,27 ± 1,22). Los resultados de los puntajes funcionales fueron: grupo 1 (15 pacientes): media 84 ASES y 84 SSV; grupo 2 (15 pacientes): media 93,40 ASES y 91,67 SSV; grupo 3 (16 pacientes): media 79,4 ASES y 80,63 SSV.

    Conclusiones: Las distintas formas de tratamiento conservador para la capsulitis adhesiva logran excelentes resultados. La analgesia mediante bloqueos seriados del nervio supraescapular con un anestésico y corticoide logró mejores resultados funcionales y subjetivos, y disminuyó la necesidad de administrar analgésicos y de sesiones de fisioterapia (grupo 1).Nivel de Evidencia: IV

  • English

    Objective: To evaluate the functional outcomes of three different conservative treatment protocols in patients with adhesive capsu-litis of the shoulder. Materials and Methods: Reviews of medical records were carried out on patients treated at the institution for adhesive capsulitis in the period between January 2016 and January 2019. 3 different treatment protocols were compared. Group 1; Suprascapular nerve block (SSNB) with local anesthetic and corticosteroid, analgesics, and physiotherapy after pain reduction. Group 2: SSNB with local anesthetic without corticosteroids, analgesics, and physiotherapy, and group 3: analgesics and physio-therapy, without SSNB. The functional outcomes were determined with the ASES scale and the subjective results were assessed with the SSV. Results:A total of 46 patients treated for adhesive capsulitis were divided into 3 groups. Group 3 presented a higher mean number of physiotherapy sessions (30.31±21.07). Group 2 had the highest mean number of SSN blocks (3.27±1.22). The results of the functional scores were: group 1 (15 patients): mean ASES 84 and mean SSV 84; group 2 (15 patients): mean ASES 93.40 and mean SSV 91.67; group 3 (16 patients): mean ASES 79.4 and mean SSV 80.63. Conclusion: The various forms of con-servative treatment for adhesive capsulitis achieve excellent outcomes. Analgesia through serial blocks of the suprascapular nerve with an anesthetic and corticosteroid achieved better functional and subjective outcomes and decreased the need to administer analgesics and physiotherapy sessions (group 1).

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