Heterotopic ossification of the shoulder after central nervous system lesion: indications for surgery and results
| Autor: | Philippe Denormandie, Alexis Schnitzler, Thierry Judet, Erwan Pansard, Christine Lautridou, François Genêt |
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| Rok vydání: | 2013 |
| Předmět: |
Adult
Male Shoulder medicine.medical_specialty Adolescent Traumatic brain injury Electromyography Young Adult medicine Humans Orthopedic Procedures Orthopedics and Sports Medicine Range of Motion Articular Spinal cord injury Stroke Spinal Cord Injuries Retrospective Studies Postoperative Care medicine.diagnostic_test Shoulder Joint business.industry Nerve Compression Syndromes Ossification Heterotopic Retrospective cohort study General Medicine Middle Aged medicine.disease Surgery Treatment Outcome Capsulitis Brain Injuries Axilla Female Heterotopic ossification Tomography X-Ray Computed business Range of motion |
| Zdroj: | Journal of Shoulder and Elbow Surgery. 22:767-774 |
| ISSN: | 1058-2746 |
| DOI: | 10.1016/j.jse.2012.08.017 |
| Popis: | Background Heterotopic ossification (HO) of the shoulder after central nervous system damage has seldom been studied. Materials and methods We performed a single-center retrospective study from 1993 to 2009 including patients who underwent surgery for troublesome shoulder HO. Demographic data, HO location, surgical approach, preoperative and postoperative shoulder range of motion, etiologies, and postoperative complications were collected from patients' files. Results We found 19 shoulder HOs in 16 patients (traumatic brain injury in 11, spinal cord injury in 2, stroke in 1, and cerebral anoxia in 2). The data in 2 files were incomplete and were therefore not used. HO locations around the joint were anteroinferomedial in 4 (21.1%), posteroinferomedial in 5 (26.3%), encircling in 3 (15.8%), superior in 1 (5.3%), and mixed (2 associated HOs that are not encircling) in 6 (31.6%). The surgical approaches were as follows: deltopectoral, 5 (26.3%); Neer, 3 (15.8%); posterior, 5 (26.3%); axillary, 1 (5.3%); Martini, 2 (10.5%); posterior associated with deltopectoral, 2 (10.5%); and Neer (superolateral) associated with deltopectoral, 1 (5.3%). The mean range of motion increased significantly (gain at follow-up of 69°, 60°, and 13° in forward elevation, abduction, and lateral rotation, respectively). Regarding postoperative complications, there was 1 case of capsulitis and 1 reoperation for insufficient excision (because of hemorrhage during surgery). There were no other side effects. Conclusion Anatomic relations with nerves and vessels, as well as limited range of motion, require a case-by-case surgical approach, a preoperative scan (looking for a gutter), and sometimes, electromyography. Surgical indications depend on the degree of loss of function or hygiene, control of comorbid factors, and discussion with the patient and his or her family. |
| Databáze: | OpenAIRE |
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