Purpose: Frozen shoulder, an excruciatingly painful condition known medically as adhesive capsulitis, affects two million people in Britain. Diabetics and women aged 40–60 are particularly at risk. The current treatment for frozen shoulder includes painkillers, physiotherapy, or surgery. The above presents their own problems, including recurrence of symptoms, failure of therapy, and for surgery: recovery period, anaesthetic and surgical operative risks. In contrast, the therapy involving hydrodilatation injections into the shoulder takes just ten minutes and allows patients to go home immediately. Hydrodilatation had fallen out of favour as a means of treating frozen shoulders until the recent publications specifically the King’s Lynn study (Quraishi et al) in 2007. Our objective is to see if we can reproduce these results that the King’s Lynn study shows.

Method: Our study is a cohort study, prospectively evaluating the outcome of hydrodilatation as treatments for adhesive capsulitis. 24 patients were treated with hydrodilatation, and had Oxford scores done before injection; 2 months and 6 months after injection. The overall scores were recorded as was the range of movement.

Results: The overall scores for the study showed a significant improvement and increased ROM of patients’ shoulders.

Conclusion: We believe our study shows that hydrodilatation is an effective means of treating frozen shoulders. We believe our study demonstrates the need for hydrodilatation to be more widely practiced. Other therapy such as painkillers and physiotherapy has shown not to be effective, and surgery has its respective complications. Therefore hydrodilatation offers a minimally invasive, cheap, low risk alternative.

Introduction: We present our results from a series of patients with symptomatic distal radial malunions. Between January 2005 and October 2008, 15 patients (11 female: 4 male) underwent corrective osteotomy using fixed-angle plates and either structural iliac crest or inlay hydroxyapa-tite (HA) graft. 2 patients had correction for palmar, and the remainder for dorsal, angulation. The mean age was 48 years. The mean time from injury to corrective osteotomy was 12 months (range 3–40 months).

Methods: Radiological parameters included ulna variance, radial inclination, palmar angulation and time to union following osteotomy. Clinical outcomes included wrist RoM, grip strength, VAS for pain and DASH score (Disability of the Arm, Shoulder and Hand) preoperatively and 3 months post-operatively.

Results: The mean change in radiographic parameters were 2mm increase in ulnar variance, 9° increase in radial inclination (14° – 23°) and 23° increase in palmar angulation (−26° – 3°). The only statistically significant change in RoM was an increase in supination from 55° preoperatively to 73° postoperatively. DASH scores improved from a mean 51 pre-op to 15 post-op, statistically and clinically significant. The mean improvement in grip strength was 8kg, and the VAS for pain improved from 5 preoperatively to 1 postoperatively.

We found a positive correlation between age and time to union/graft incorporation (R2 = 0.47). The mean time to graft incorporation was 16 weeks. All of the patients treated with iliac crest structural graft progressed to union. Only 2 of the 4 patients treated with HA graft achieved incorporation, while the other 2 have required revision surgery.

Conclusion: Our results therefore show a significant improvement in both radiological and clinical outcome measures following corrective surgery. We had inferior results with the HA graft, and have subsequently abandoned its use. These results support the use of corrective osteotomy following distal radial malunion.