Double Trouble of "Double Segmental" Fractures - A Report of Two Cases.

INTRODUCTION: Adhesive capsulitis of shoulder is a commoner condition in middle aged population and is classified into primary and secondary types based on etiology. Treatment options depend on stages of disease which ranges from physical therapy, non-steroidal anti-inflammatory medications, intra-articular steroid injection, hydro-dilatation therapy, manipulation under anesthesia, and arthroscopic capsular release. However, the condition is generally mismanaged by untrained professionals in the periphery center leading to complications. We report one such case, which was then managed arthroscopically.

CASE REPORT: A 58-year-old female patient presented to our outpatient department with a severe painful left shoulder following overzealous manipulation by untrained professional and she was diagnosed with severe traumatic capsulosynovitis with a subscapularis tear, biceps tendon subluxation, and shoulder subluxation. We managed patient arthroscopically with extensive capsulosynovectomy, biceps tenotomy, and upper subscapularis repair. Postoperatively, she was immobilized for 6 weeks and was put on proper rehabilitation program. At the 2-year follow-up, the patient had an excellent outcome and had complete pain-free movements at the left shoulder with significant increase in pre-operative constant shoulder score of 12-82.

CONCLUSION: ?Overzealous manipulation shoulder in frozen shoulder patients has serious complications and has to be avoided and therefore has to be done by trained professional gently under anesthesia. Shoulder arthroscopy plays a pivotal role in managing such complications successfully.