A Case Report of Stiff Shoulder with Traumatic Neuroma.

概要

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We experienced a rare case of stiff shoulder with traumatic neuroma. The patient was a 52 year old male who presented complaining of pain and motion disturbance in his shoulder joint. In May 1994 he fell down the stairs hitting the upper side of his right shoulder and developed a bruise and shoulder pain. When he came to our hospital, active flexion of his shoulder was 95 degrees and active abduction was 80 degrees. Arthrogram and MRI did not show a rotator cuff tear, except for a contrast finding on the arthrography. 50% of his shoulder pain was relieved by injection into the glenohumeral joint, subacromial bursa and acromio-clavicular joint with local anesthetic. In March 1995 arthroscopic surgery which released the coraco-acromial ligament and the joint capsule was performed. However, post-operatively, his shoulder discomfort continued and he could not tolerate the rehabilitation program. One month after his first surgery, the local anesthetic test was repeated. His pain was not relieved by injection into the joint capsule and the subacromial bursa. The injected agent flowed out from the acromio-clavicular joint. In 1995 surgery was performed and a traumatic neuroma recognized outside of the clavicle. After resection of the neuroma, his shoulder discomfort significantly improved and it was possible for him to perform the rehabilitation program.