Results of excision of heterotopic new bone around the elbow in patients with head injuries. A series of 25 cases.
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.
Denormandie
P
P
Service de Chirurgie Orthopédique et Traumatologique, Hôpital Raymond Poincaré, Garches.
Viguie
G
G
Denys
P
P
Dizien
O
O
Carlier
R
R
D000328:Adult; D000844:Ankylosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D001177:Arthropathy, Neurogenic / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D001930:Brain Injuries / Q000150:complications*; D003287:Contrast Media; D006259:Craniocerebral Trauma / Q000150:complications*; D004551:Elbow Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D004576:Electromyography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007091:Image Processing, Computer-Assisted; D017746:Joint Capsule / Q000601:surgery; D008297:Male; D020423:Median Neuropathy / Q000209:etiology / Q000601:surgery; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000601:surgery; D009408:Nerve Compression Syndromes / Q000209:etiology / Q000601:surgery; D010027:Osteotomy; D011856:Radiographic Image Enhancement; D016059:Range of Motion, Articular; D013710:Tendons / Q000601:surgery; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D017769:Ulnar Nerve Compression Syndromes / Q000209:etiology / Q000601:surgery
D003287:Contrast Media