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General Orthopaedics

OUTCOME OF ARTHROSCOPIC SUBACROMIAL DECOMPRESSION FOR SHOULDER IMPINGEMENT FOLLOWING A WHIPLASH INJURY

The Indian Orthopaedic Society (UK) (IOSUK)



Abstract

Introduction

Whiplash injury following rear shunt Road traffic accident (RTA) has been associated with impingement syndrome of shoulder. However, the results of arthroscopic subacromial decompression (ASAD) for this group of patients have never been compared to the non accident group. In our study we aim to compare the results of ASAD in these patients to a group who did not sustain whiplash injury.

Materials/Methods

Thirteen patients with impingement syndrome following rear shunt RTA were followed up (2004–09). After failed conservative management for at least 6 months ASAD was performed. This group was compared with a control group (not involved in an RTA) of 13 consecutive patients (age and sex matched). All patients were assessed with Oxford shoulder score preoperatively and twice post operatively (within 3 months and at one year).

Results

In the RTA group all 13 patients showed improvement in their oxford score over one year. While the improvement was only Marginal (p= 0.08) at three months it was better at the end of a year (p=0.04). Comparatively in the cohort without the whiplash injury the improvement was more marked in the first three months (p=0.05) with significant improvement at the end of the year (p=0.03). The overall improvement in Oxford score was more in the cohort of patients who were not involved in a RTA as opposed to the RTA group (p= 0.05).

Conclusion

The results of the study show that even though there was an improvement in shoulder scores after an arthroscopic subacromial decompression it was much slower and overall results were inferior in the RTA group as opposed to the controls and hence prognosis should be guarded when offering ASAD for patients with whiplash injury.