title: Bilateral Scapulohumeral Ankylosis after Prolonged Mechanical Ventilation.
abstract: This case demonstrates a rarely reported bilateral scapulohumeral bony ankylosis. A young woman developed extensive heterotopic ossifications (HOs) in both shoulder joints after being mechanically ventilated for several months at the intensive care unit in a comatose status. She presented with a severe movement restriction of both shoulder joints. Surgical resection of the bony bridges was performed in 2 separate sessions with a significant improvement of shoulder function afterwards. No postoperative complications, pain, or recurrence of HOs were noted at 1-year follow-up. Mechanical ventilation, immobilization, neuromuscular blockage, and prolonged sedation are known risk factors for the development of HOs in the shoulder joints. Relatively early surgical resection of the HOs can be performed safely in contrary to earlier belief. Afterwards, nonsteroidal anti-inflammatory drugs and/or radiation therapy can be possible treatment modalities to prevent recurrence of HOs.
authors: Division of Orthopaedic Surgery, Spaarne Gasthuis, Spaarnepoort, Hoofddorp, Netherlands.
authors: Manon L
authors: ML
authors: van Lotten
authors: Division of Anaesthesiology, VU University Medical Centre, De Boelelaan, Amsterdam, Netherlands.
authors: J Rieneke
authors: JR
authors: Schreinemakers
authors: Division of Orthopaedic Surgery, Spaarne Gasthuis, Spaarnepoort, Hoofddorp, Netherlands.
authors: Arthur
authors: A
authors: van Noort
authors: Division of Orthopaedic Surgery, Spaarne Gasthuis, Spaarnepoort, Hoofddorp, Netherlands.
authors: Maarten V
authors: MV
authors: Rademakers
mesh_terms: D000328:Adult; D000844:Ankylosis / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D016059:Range of Motion, Articular; D012121:Respiration, Artificial / Q000009:adverse effects*; D012785:Shoulder Joint / Q000000981:diagnostic imaging / Q000503:physiopathology; D014057:Tomography, X-Ray Computed
keywords: Ankylosis; Artificial respiration; Heterotopic ossification; Shoulder joint