Results of excision of heterotopic new bone around the elbow in patients with head injuries. A series of 25 cases

Chir Main. 1999;18(2):99-107. doi: 10.1016/s0753-9053(99)80062-3.

Abstract

Twenty patients were operated upon for heterotopic ossification around the elbow of neurogenic origin following intra-cranial trauma between 1993 and 1997. They did not receive any diphosphonates or radiotherapy. Pre-operative evaluation included a CT scan with enhancement using a dye injected intravenously and 3D reconstruction. Surgery was indicated in the presence of a clinical deficit in mobility or signs (clinical or electrical) of nerve compression. The average delay between the accident and the surgery was 34 months (5 months to 9 years). Associated procedure included lengthening of the brachialis (4 cases), lengthening of the triceps tendon (4 cases) and an anterior capsulotomy in 3 cases. 24 elbows were reviewed with an average follow-up period of 18 months (6 months to 4 years). In 58% of the cases, the result was very good (gain in mobility > 70%) while in the remaining 42% of cases, the improvement was between 40% and 70%. This study confirms the possibility of obtaining good results by excision of the masses of heterotopic ossification of neurogenic origin around the elbow before 1 year after the accident without the necessity of complementary treatment.

MeSH terms

  • Adult
  • Ankylosis / diagnostic imaging
  • Ankylosis / etiology
  • Ankylosis / surgery*
  • Arthropathy, Neurogenic / diagnostic imaging
  • Arthropathy, Neurogenic / etiology
  • Arthropathy, Neurogenic / surgery*
  • Brain Injuries / complications*
  • Contrast Media
  • Craniocerebral Trauma / complications*
  • Elbow Joint / diagnostic imaging
  • Elbow Joint / surgery*
  • Electromyography
  • Female
  • Follow-Up Studies
  • Humans
  • Image Processing, Computer-Assisted
  • Joint Capsule / surgery
  • Male
  • Median Neuropathy / etiology
  • Median Neuropathy / surgery
  • Middle Aged
  • Muscle, Skeletal / surgery
  • Nerve Compression Syndromes / etiology
  • Nerve Compression Syndromes / surgery
  • Osteotomy*
  • Radiographic Image Enhancement
  • Range of Motion, Articular
  • Tendons / surgery
  • Time Factors
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Ulnar Nerve Compression Syndromes / etiology
  • Ulnar Nerve Compression Syndromes / surgery

Substances

  • Contrast Media