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July 28, 1956


JAMA. 1956;161(13):1219-1222. doi:10.1001/jama.1956.02970130007002

• Immobility of the articulatio humeri sets in most frequently in middle life. It is usually ascribed to some minor trauma, but in reality the cause and exact nature of the derangement are both in doubt.

The treatment recommended here consists of hospitalization, closely supervised therapeutic exercise, and manipulation of the joint at several sessions with the patient under general anesthesia. Complete mobilization must not be expected at the first session but is achieved in stages. The exercise program continues during the intervals of three to five days between manipulations.

Ninety-six patients who had been treated for "frozen" shoulder in this way responded later to a detailed questionnaire and also returned for a physical examination. The results of the treatment were thus evaluated by both subjective and objective criteria. Open operation alone can yield the explanation of this condition, but the closed method here advocated gave results classified as good to excellent by objective as well as subjective criteria, and it was not followed by complications in any case.