目的：为原发性冻结肩的扩张治疗达成专家临床共识，为临床实践和评估干预措施的设计提供参考。
方法：我们进行了两个阶段，基于电子问卷，修改了德尔福对英国NHS肩部专家的调查。第一轮要求肯定，负,或关于加氢膨胀的中性评级。在第二轮中，每个参与者被提醒他们的第一轮反应和所有参与者的模态(或\'组\')反应.这允许参与者在第二轮中修改他们的回答。我们分别提出了100%和90%积极共识的强制或鼓励加氢扩张要素，分别以90%和80%的负面共识不允许或不鼓励。其他元素将是可选的。
结果：在2020年8月4日至2021年8月4日期间，来自英国47家医院的肩部专家完成了这项研究。有106名参与者(上肢骨科顾问，n=50；放射科顾问，n=52；物理治疗师顾问，n=1；扩展范围物理治疗师，n=3)完成第一轮的人，其中97人(92%)完成第二轮。没有“强制”加氢扩张的元素(100%正面评级)。“鼓励”的元素（≥80％的正面评级）是使用图像指导，局部麻醉,生理盐水,和类固醇注射。根据患者的耐受性进行注射，物理治疗,家庭锻炼也被“鼓励”。尽管使用高渗盐水被评为“不允许”（≥90％负面评级），但没有任何元素被“劝阻”（≥80％负面评级）。
结论：在缺乏严格证据的情况下，我们的德尔福研究使我们能够达成专家共识，负,在医院环境中，在冻结肩的管理中，加氢扩张的中性评级。这应该为临床实践和评估干预措施的设计提供信息。引用这篇文章：BoneJtOpen2022；3（9）：701-709。
OBJECTIVE: To achieve expert clinical
consensus in the delivery of hydrodilatation for the treatment of primary frozen shoulder to inform clinical practice and the design of an intervention for evaluation.
METHODS: We conducted a two-stage, electronic questionnaire-based, modified Delphi survey of shoulder experts in the UK NHS. Round one required positive, negative, or neutral ratings about hydrodilatation. In round two, each participant was reminded of their round one responses and the modal (or \'group\') response from all participants. This allowed participants to modify their responses in round two. We proposed respectively mandating or encouraging elements of hydrodilatation with 100% and 90% positive
consensus, and respectively disallowing or discouraging with 90% and 80% negative
consensus. Other elements would be optional.
RESULTS: Between 4 August 2020 and 4 August 2021, shoulder experts from 47 hospitals in the UK completed the study. There were 106 participants (consultant upper limb orthopaedic surgeons, n = 50; consultant radiologists, n = 52; consultant physiotherapist, n = 1; extended scope physiotherapists, n = 3) who completed round one, of whom 97 (92%) completed round two. No elements of hydrodilatation were \"mandated\" (100% positive rating). Elements that were \"encouraged\" (≥ 80% positive rating) were the use of image guidance, local anaesthetic, normal saline, and steroids to deliver the injection. Injecting according to patient tolerance, physiotherapy, and home exercises were also \"encouraged\". No elements were \"discouraged\" (≥ 80% negative rating) although using hypertonic saline was rated as being \"disallowed\" (≥ 90% negative rating).
CONCLUSIONS: In the absence of rigorous evidence, our Delphi study allowed us to achieve expert
consensus about positive, negative, and neutral ratings of hydrodilatation in the management of frozen shoulder in a hospital setting. This should inform clinical practice and the design of an intervention for evaluation.Cite this article: Bone Jt Open 2022;3(9):701-709.
