Management of multijoint stiffness of bilateral upper limbs secondary to heterotopic ossification: Case report and literature review

Min, Hong-wei; Liu, Kemin; Han, Xinzuo; Gu, Rui

doi:10.1682/jrrd.2013.03.0073

Cited by 4 publications

(1 citation statement)

References 29 publications

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“…7,11 HO of the shoulder is rare, even in the setting of arthroscopic surgery 7 ; when present, it is typically asymptomatic and not clinically significant. 11 To the best of our knowledge, 26 cases of nontraumatic HO of the shoulder have been described in English literature: nine infectious, [12][13][14][15][16][17][18][19] six genetic, [20][21][22][23][24][25] six neurologic, [26][27][28][29][30][31] three autoimmune, [32][33][34] one druginduced, 35 and one idiopathic. Although the etiology of HO is diverse, the pathophysiology is thought to be the same across all subtypes.…”

Section: Discussionmentioning

confidence: 99%

Idiopathic Spontaneous Occurrence of Heterotrophic Occurrence During Pregnancy

et al. 2023

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Heterotopic ossification (HO) typically presents in the hip, knee, and elbow joints in the setting of trauma or postsurgical intervention. Less commonly, it may occur secondary to neurologic dysfunction or underlying genetic conditions, but idiopathic HO is rare. Most cases of HO are managed nonoperatively with surgical resection remaining a controversy due to high recurrence rates. We describe a case of idiopathic HO of the shoulder that occurred in the absence of trauma, neurologic dysfunction, or underlying genetic disorder that was treated with surgical excision. Heterotopic ossification (HO) is the formation of ectopic bone within the soft tissues. 1 HO can be classified into three broad categories based on etiology: traumatic HO from fractures, dislocations, orthopaedic surgeries, and burns; neurogenic HO from spinal cord damage or head injury; and genetic HO from conditions, such as progressive fibrodysplasia ossificans or progressive osseous heteroplasia. 2 Traumatic HO comprises up to 90% of cases, most commonly a complication of arthroplasty or bone fracture, with a higher predisposition for men. 3 Although it can occur anywhere in the body, HO typically affects areas most susceptible to trauma, such as the elbow, thigh, pelvis, and shoulder. 4 When symptomatic, HO can present with pain, decreased range of motion, and in severe cases, bony ankylosis. 2 The diagnosis is made with radiographic imaging, including radiographs, CT, and MRI. Several classification systems have been used to grade the severity of HO, but the Brooker Classification System used for HO at the hip 5 and the Hastings and Graham System for HO at the elbow 6 are two of the most commonly used.A definitive diagnosis of HO can be made by histopathologic evaluation of a tissue sample. HO is often defined pathologically by the type of tissue in which it occurs, such as myositis ossificans involving skeletal muscle. The histopathologic features of the lesion typically evolve over time, with early lesions being composed of cellular fibrovascular tissue with small amounts of bone matrix. More mature lesions have prominent bone formation with a zonal architecture, a hallmark of HO. It is important to differentiate HO from a neoplastic process, such as soft-tissue sarcoma or osteosarcoma. Microscopically, in more mature lesions, trabeculae of woven bone with osteoblastic rimming accompanied by more mature lamellar bone is more

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Section: Discussionmentioning

confidence: 99%

Idiopathic Spontaneous Occurrence of Heterotrophic Occurrence During Pregnancy

et al. 2023

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Early functional mobilization for non-operative treatment of simple elbow dislocations: a systematic review

et al. 2020

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Purpose This systematic review aims to elucidate a non-operative rehabilitation program that optimizes recovery based on published approaches and outcomes. Methods Searches of four databases from inception to 1 January 2020 were performed to identify clinical studies addressing the non-operative management of simple elbow dislocations. Results Of 2435 studies that were eligible for title screen, 15 studies satisfied inclusion criteria. Three randomized control studies demonstrated that early mobilization expedited the return of range of motion, function and return to work or activities, however, resulted in increased pain within the six-week rehabilitation period compared to Plaster of Paris casting for 21 days. Patients returned to work sooner after early mobilization (10 vs. 18 days; p = 0.02) compared to Plaster of Paris casting. In all studies, early mobilization resulted in similar re-dislocation rates of 1.3% (3/237) versus 2.2% (12/549) in those with Plaster of Paris casting as well as lower incidence of heterotopic ossification (36% vs. 54%). No significant differences between rehabilitation protocols were determined; however, the large majority of recent papers utilized rehabilitation protocols. Conclusion Early mobilization of simple elbow dislocations results in early return of Range-of-Motion, function and return to work with no increase in complication rates; however, increased pain during the rehabilitation period.

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Neurogenic Arthropathies of the Lower Limbs: About A Case Followed in Rehabilitation at the Chu-Bogodogo

Tiaho,

Charles,

Louis

et al. 2024

SPMRJ

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we report a case of pelvic limb neurogenic arthropathies (NA) in a young 25-year-old patient following severe cranioencephalic trauma in a road traffic accident. The aim of this clinical case was to report the contribution of physical medicine and rehabilitation in the management of neurogenic arthropathies. The patient was admitted to the Physical Medicine and Rehabilitation Department only six months after his trauma. Nervous system disorders were represented by a frontal syndrome and significant spasticity in the pelvic limbs. Deficiencies founds was pain, multiple joint stiffness of the pelvic limbs, induration of the thighs related to arthropathies objectified to the standard x-ray of the thighs. The rehabilitation approach consisted of postures associated with targeted cryotherapy of the muscles. The gait rehabilitation was done gradually between the parallel bars and then with a deanbulator Rehabilitation led to functional improvement, with the patient returning to independent walking using simple techniques. The presentation of this case study provided an overview of this pathology, its functional consequences and the role of Physical and Rehabilitation Medicine in the management of NA. The techniques we used have made it possible to limit the diffusion processes of neurogenic arthropathies by limiting inflammation through associated cryotherapy sessions. The presence of nervous system disorder such as frontal syndrome could have limited rehabilitation, but thanks to collaboration with psychiatrists the evolution was favorable and allowed the patient to actively participate in his rehabilitationThe case also underlined the importance of multidisciplinary patient management, which should be a goal for all practitioners. Keywords: arthropathies ; cryotherapy ; neurogenic ; rehabilitation ; traumatic brain injury

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Management of multijoint stiffness of bilateral upper limbs secondary to heterotopic ossification: Case report and literature review

Cited by 4 publications

References 29 publications

Idiopathic Spontaneous Occurrence of Heterotrophic Occurrence During Pregnancy

Idiopathic Spontaneous Occurrence of Heterotrophic Occurrence During Pregnancy

Early functional mobilization for non-operative treatment of simple elbow dislocations: a systematic review

Neurogenic Arthropathies of the Lower Limbs: About A Case Followed in Rehabilitation at the Chu-Bogodogo

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