Heterotopic ossification of the shoulder after central nervous system lesion: indications for surgery and results.
J Shoulder Elbow Surg
; 22(6): 767-74, 2013 Jun.
Article
em En
| MEDLINE
| ID: mdl-23246198
ABSTRACT
BACKGROUND:
Heterotopic ossification (HO) of the shoulder after central nervous system damage has seldom been studied. MATERIALS ANDMETHODS:
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.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Ombro
/
Traumatismos da Medula Espinal
/
Axila
/
Lesões Encefálicas
Tipo de estudo:
Observational_studies
/
Risk_factors_studies
Limite:
Adolescent
/
Adult
/
Female
/
Humans
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Male
/
Middle aged
Idioma:
En
Revista:
J Shoulder Elbow Surg
Assunto da revista:
ORTOPEDIA
Ano de publicação:
2013
Tipo de documento:
Article
País de afiliação:
França