次發性冰凍肩︰病例報告及文獻回顧

The Secondary Frozen Shouler: Case Presentation and Literature Review

吳坤霖(Kuen-Lin Wu) ； 許書榮(Shu-Yeh Sheu) ； 周崇頌(Chorng-Song Chou) ； 徐弘正(Horng-Jeng Shyn) ； 徐道昌(Tao-Chang Hsu)

《中華民國復健醫學會雜誌》 20期 (1992/12) Pp. 185-189

摘要

臨床上，冰凍肩是常的病例，大部份病例無特定原因，但很多疾病有冰凍肩的復遺症。本文報告四病例，起初以為是原因單純的冰凍肩，後來皆發現有其他原因，所以提供臨床醫師參考。病例一和病例二隱藏有惡性腫瘤，病例三和病例四是車禍造成前臂骨折，合併肩部疼痛，本以為是固定不動引起，但後來發現前者因肱骨頭骨折，後者因旋轉帶裂傷。提出這四病例，並回顧相關文獻，建議臨床醫師應常追蹤病人病況和理學檢查，若治療效果不如醫師所期望者，應進一步考慮是否隱藏其他問題，期能早期診斷和適當治療。

關鍵字

冰凍肩 ； 惡性腫瘤 ； 骨折 ； 固定不動

並列摘要

Capsular tightening at the shoulder is a common disorder, usually referred to as frozen of cases seen by physiatrist are those in which no specific cause can be determined for the stiffening. It may also be a sequela of other diseases, such as stroke, fracture, malignancy, etc. We present four cases of secondary frozen shoulder without conspicuous etiology. The case 1 and 2 had the underlined malignancy. The case 3 and 4 suffered from fracture of forearm and painful sensation over the shoulder joint due to traffic accident. The first impression was secondary frozen shoulder due to proloned immobilization. However, the former had impact fracture of humeral head and the latter had rotator cuff tear. The for cases remind us that thorough history taking and careful physical examination are essential in diagnosing frozen shoulder. The therapeutic effect and course should be followed up closely. Further study is indicated if the therapeutic effect is not compatible with the clinical course.