Retrospective analysis of ultrasound-guided hydrodistension in patients with post-traumatic adhesive capsulitis of the shoulder

Background: Adhesive capsulitis (AC) is a painful shoulder condition characterized by limited motion due to fibrosis and contracture of the joint capsule. Secondary AC frequently occurs after upper limb fractures and immobilization, delaying recovery. Methods: This retrospective study analyzed 11 patients with post-traumatic AC (< 3 months) following non-displaced humeral fractures treated conservatively with a median immobilization period of 25 days. The cohort included seven men and four women (mean age 52.6 years), five of whom also had rotator cuff injuries. Treatments involved hydrodistension, with glenohumeral drainage in seven cases and subacromial bursa drainage in four cases. Range of motion (ROM), pain (VAS), and functionality (DASH) were assessed at baseline, 1-, 2-, and 3-month post-treatment. Results: Significant improvements in ROM were seen across all planes: flexion increased from 80° to 150°, extension from 15° to 60°, abduction from 55° to 160°, internal rotation from 10° to 85°, and external rotation from 10° to 80° (all p < 0.001). Pain levels (VAS) decreased from a mean score of 8 at baseline to 3 at 3 months (p < 0.001), and functional capacity (DASH) improved from a score of 45–10 (p < 0.001). Among the five patients with rotator cuff injuries, despite improved ROM and pain, strength deficits persisted, leading to subsequent arthroscopic repairs. Conclusion: Hydrodistension resulted in significant improvements in ROM, pain relief, and functionality, suggesting it is a promising treatment for post-traumatic AC. Early intervention may aid faster recovery after shoulder immobilization.