Simon Duplay, scapulohumeral periarthritis, and stiff shoulder

In 1872, Simon-Emmanuel Duplay (1836–1924), surgeon of the Paris hospitals and professor of surgical clinical medicine, published a monograph describing a chronic shoulder condition which he named scapulohumeral periarthritis (SHP). Working at a time when no imaging modality was available — X-rays would not be discovered until 1895 — Duplay relied exclusively on clinical observation, examination under chloroform anaesthesia, and post-mortem dissection to characterise a distinctive clinical picture: restriction of shoulder movement, particularly abduction, accompanied by pain only on mobilisation, without deformity or swelling of the joint. A pivotal post-mortem examination performed on a patient who had undergone manipulation under anaesthesia allowed him to demonstrate that the glenohumeral joint itself was intact, and that stiffness arose from extra-articular lesions — thickening of the subacromial bursa and fibrous adhesions between the humeral head, the coracoacromial arch, and the deep surface of the deltoid. In 1897, in his Cliniques Chirurgicales de l’Hôtel-Dieu, he confirmed and extended these findings, acknowledging that SHP was not invariably post-traumatic. This article retraces Duplay’s clinical and anatomical reasoning, his therapeutic proposals — massage, assisted mobilisation, hydrotherapy, electrical stimulation, and, when necessary, forcible manipulation under anaesthesia — and the legacy of his work through subsequent authors: Meyer and Pasteur on the long head of the biceps, Codman and his concept of frozen shoulder, Neviaser’s description of adhesive capsulitis, Steinbrocker’s shoulder-hand syndrome, the French rheumatological school’s fourfold classification by de Sèze, and the modern primary/secondary dichotomy following Lundberg. By tracing the evolution from a single eponymous entity to today’s nosological framework, the article situates Duplay as the pioneer of the vast and still incompletely understood domain of shoulder stiffness, and offers orthopaedic surgeons, rheumatologists, and medical historians a useful perspective on the conceptual foundations underpinning current practice.