Abstract

Introduction: After shoulder subacromial decompression (SAD) and Acromioclavicular joint (ACJ) excision when the patient for whatever reason does not mobilize shoulder according to a postoperative protocol becomes stiff and as the pain increases the stiffness worsens and end up in a vicious cycle.

We are presenting our use of continuous brachial plexus block in stiff shoulders following surgery with an acceptable outcome.

Method: A retrospective study was conducted in Walsall Manor Hospital of the patient undergoing Continuous Brachial plexus Block from January 2014 to December 2018 in patients with secondary frozen shoulder following simple post-arthroscopy Sub-acromial decompression (SAD) +/- acromioclavicular joint (ACJ) excision. Patients underwent Physiotherapy and were then followed up in the clinic at 8 weeks. About 90% were discharged at this stage. However, about 6 weeks further physiotherapy was offered to the strugglers. The Resistant cases were included after being filtered out for disc disease and Local anesthetic complications. All people fulfilling the criteria were listed for continuous brachial plexus block with a catheter for 48 hours along with physiotherapy. Patients followed and reviewed at 6/52 6/12 and 1 year. Constant score (1) was calculated at admission and 1 year follow up. Data analyzed using SPSS 20.0.

Results: 401 shoulder arthroscopy for subacromial decompression and acromioclavicular joint decompression were carried out in a period of 5 years. At 14 weeks follow up post-surgery 28 patients were still struggling with pain and stiffness. Cervical disc disease of C5/C6 has been diagnosed in 5 patients and excluded from the study. Of the 23 patients ended up with being listed for Continuous Brachial plexus block. At 1-year post-block facilitated aggressive physiotherapy (for initial 48 hours) patients had remarkably improved clinical and functional outcomes.

Conclusion: We report that in resistant cases after simple arthroscopy posterior capsule tightness is a cause and a continuous brachial plexus block is an ideal treatment with satisfactory results.

Keywords: Shoulder Arthroscopy; Post Arthroscopy stiffness, continuous Brachial plexus block

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Citation

Citation: Munawar Shah., et al. “Brachial Plexus Continuous Block in Management of Stiff Post Arthroscopy Shoulders".Acta Scientific Orthopaedics 4.1 (2021): 43-47.

Copyright

Copyright: © 2021 Munawar Shah., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.