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At least 955 records · Page 53Linked to original sources
PubMed1989

Postburn heterotopic ossification: insights for management decision making.

An analysis of 1,478 consecutive admissions to the University of Kansas Burnett Burn Center revealed 18 patients who developed heterotopic ossification (1.2% incidence). Seventeen patients developed this disease in the elbows; one patient had shoulder involvement. Two patients eventually developed bilateral elbow disease. All patients initially presented with pain and limitation of joint motion. The diagnosis was then confirmed radiographically. All patients suspected of heterotopic ossification received physical therapy consisting of active range of motion only. Ten patients responded to conservative treatment and regained functional range of motion, and eight patients developed refractory ankylosis requiring surgical management. All surgically managed patients achieved a functional range of motion with an average followup of 35.0 months.

Adult↗
PubMed1989

Spinal cord insults and heterotopic ossification in the pediatric population.

Fifteen of 152 pediatric patients with spinal cord insults (10%) developed heterotopic ossification (HO) at 19 locations. The average age of the patient was eight and one-half years. The spinal cord levels were 13 thoracic and two cervical. The average time to detection of the HO from spinal insult was six and one-half years. The hip was involved in 15 of 19 HO lesions. Decreased range of motion of the affected extremity was the most common sign of occurrence. Alkaline phosphatase was elevated in five of eight patients at the time of detection. Three patients had some resorption of the HO, and one had nearly complete resorption. Five patients (3.3%) with HO had no other etiologic agent other than the neurologic insult, and their average age at time of injury was 13 and one-half years. The hip was involved in six of seven instances. The average time to diagnose this HO was 14 months after injury. Ten patients had late concurrent etiologic factors such as surgery, decubitus ulcers, late neurogenic hip dislocation, and late acute local trauma influencing HO formation. Pediatric patients who developed HO appeared to have a lower incidence, delayed onset, and fewer associated signs and symptoms compared with their adult counterparts with spinal cord injury. Patterns of ossification about the hip differ from adults. The HO lesion has the potential to resorb. HO may be initiated years after the spinal injury by an incidental insult.

Adolescent↗
PubMed1989

Osteoma cutis associated with disordered ossification of the clavicle. A case report.

Congenital multiple osteomas of the skin associated with disordered ossification of the clavicle occurred in a four-year-old boy. There were no clinical and laboratory findings of pseudohypoparathyroidism, pseudopseudohypoparathyroidism, or fibrodysplasia ossificans progressiva in this case. The clavicular bony mass was excised in segments. Samples of the cutaneous osteomas were removed for histologic study. On microscopic examination, the specimen from the clavicle consisted of trabecular bone in hyaline cartilage, resembling enchondral ossification, but the specimen from the osteoma cutis revealed a mature membraneous bone without cartilage.

Child, Preschool↗
PubMed1989

[Post-traumatic ossifications simulating soft tissue neoplasms].

Roentgenologic data on 59 patients in whom posttraumatic calcification and ossification simulated soft tissue tumor were evaluated. X-ray diagnostic and differential diagnostic features are discussed. Soft tissue X-ray proved to be best suited in ossification identification.

Adolescent↗
PubMed1989

Total (anterior and posterior) decompression of the spinal cord: surgical treatment for combined ossification of the posterior longitudinal ligament and yellow ligament of the thoracic spine.

The ossification of the posterior longitudinal ligament (OPLL) combined with ossification of the yellow ligament (OYL) in the thoracic spine can compress the spinal cord from the anterior and posterior direction, resulting in serious myelopathy. For these cases we devised a treatment consisting of two steps, total decompression of the spinal cord. The first step is removal of ossified yellow ligament posteriorly following wide laminectomy and the second step is removal of ossified posterior longitudinal ligament anteriorly, followed by interbody fusion. As the final procedure of the first step, two parallel deep gutters, covering the complete length of the ossified ligament to be removed anteriorly, are drilled from the posterior direction into the vertebral body along both sides of the dura. This pretreatment makes removal of the ossified ligament from the anterior, during the second stage, much easier and safer. This operation appears to be a promising operative procedure from our seven case experiences so far.

Adult↗
PubMed1989

[Cervical myelopathy caused by ossification of the posterior longitudinal ligament].

The clinical material presented by the authors includes 24 observations of patients with ossification of the posterior longitudinal ligament. In all cases there was a cervical spine injury in the patients', past history. The diagnosis was confirmed roentgenologically and by the method of computer tomography. The treatment is surgical and consists in anterior decompression of the spinal cord. Recovery was observed in 10 patients (42 +/- 10%), partial regress of myelopathy in 9 patients (29 +/- 10%) and discontinuation (12 +/- 6%); there was no effect in 2 patients of progress of the disease in 3 patients (8 +/- 6%) patients. The authors consider it is necessary to make a careful examination of the patients with myelopathy having a cervical spine injury in their past history in order to reveal ossification of the posterior longitudinal ligament and carry on timely surgical treatment.

Adult↗
PubMed1986

Heterotopic ossification masquerading as deep venous thrombosis in head-injured adult: complications of anticoagulation.

A 26-year-old man manifested clinical signs of a left iliofemoral thrombosis 12 weeks after closed head injury in a motor vehicle accident. The deep vein thrombosis was initially diagnosed by venography and appropriate anticoagulation therapy was instituted. After four days of treatment, there was no significant resolution of signs or symptoms and the circumference of the left thigh had increased with an associated decrease in hemoglobin. A CT scan of the involved thigh revealed hemorrhage and calcification within the quadriceps muscle. In retrospect, it was evident that the hemorrhage and heterotopic ossification had caused compression of the surrounding tissue and vessels thus mimicking a deep vein thrombosis on venography. Clinicians need to be aware of the similarity of the early clinical manifestations of heterotopic ossifications and deep vein thrombosis and the complications which could arise with anticoagulation therapy initiated too early in the course of the disease.

Adult↗
PubMed1986

[An epidemiological study on the ossification of the anterior longitudinal ligament of the spine].

An epidemiological study was carried out in connection with the multiphasic screening examination of 1,057 people (442 men and 615 women) in the village of Yachiho. The purpose of this study was to define the etiology of OALL (ossification of the anterior longitudinal ligament) and disc narrowing. The prevalence of disc narrowing increased with age, but OALL was not correlated with aging. OALL was found more frequently in men, but disc narrowing showed no difference between each sexes. The body height and weight-height index were higher in the OALL cases. The body height shrinkage by aging was greater in the patients with disc narrowing cases. The index of thoracic kyphosis was higher in the OALL cases than in the patients with disc narrowing ones. OALL was associated with ossification of the other ligaments of the spine, but disc narrowing was not. This study suggests that despite some similarities, OALL is etiologically different from disc narrowing.

Aging↗
PubMed1986

[Histopathological studies of the osteophytes and ossification of the posterior longitudinal ligament (OPLL) in the cervical spine].

To obtain information on ossification around the vertebral body of the cervical spine, we carried out histopathological investigation on 30 autopsy cases. The results were as follows; Intervertebral discs were untouched, anterior osteophytes developed along the anterior longitudinal ligament and they corresponded to anterior spur in spondylosis deformans. Posterior osteophytes around the posterior edges of vertebral body resulted in intervertebral insufficiency, and corresponded to hypertrophic spur in osteochondrosis. Histopathological findings of hyperostotic anterior osteophytes were similar to anterior osteophytes, but in the former there were advanced osteophyte formations. In OPLL of the segmental type, intervertebral discs were degenerated, and ossified mass did not involve the posterior longitudinal ligament of the parts of discs. With regard to morphological appearance and the tendency of increasing ossification, OPLL of the continuous type was similar to hyperostotic anterior osteophytes, without involvement of intervertebral disc. OPLL of the distinctly continuous type was differentiated from that of the segmental type.

Adult↗
PubMed1986

Heterotopic ossification of the shoulder following head injury. A case report.

Heterotopic ossification of the shoulder following head injury is a rare occurrence. In a 26-year-old woman with a head injury and extraarticular ossification of the glenohumeral joint, the heterotopic bone was resected surgically when the mass had matured. A vigorous physical therapy program was instituted early after operation to maintain shoulder mobility. Despite the formation of adhesions, the partial reformation of heterotopic bone, and an axillary neuropraxia, the patient achieved an excellent range of active shoulder motion ten months after operation.

Adult↗
PubMed1987

Heterotopic ossification and pseudoarthrosis in the shoulder following encephalitis. A case report and review of the literature.

Heterotopic bone formation, or myositis ossificans, is common, particularly following trauma, total hip arthroplasty, spinal cord injury, severe head injury, and long-term coma. Although the mechanism is unknown, the pathogenesis is assumed to depend on transformation of mesenchymal cells to bone forming cells in response to a variety of stimuli. The clinical findings, laboratory data, roentgenograms, and radionuclide studies are standard aids in the diagnosis of heterotopic ossification. The treatment usually consists of range-of-motion exercise, nonsteroidal antiinflammatory drugs, X-ray therapy, disodium etidronate (EHDP), and excisional surgery. Reported here is a rare case of periarticular heterotopic ossification in the shoulder of a 38-year-old woman following head injury and 13 months in a coma. The unusual feature was the development of a pseudoarthrosis within the heterotopic bone. The patient's shoulder became markedly stiff with the development of a heterotopic pseudoarthrosis. Excision of the heterotopic bone and pseudoarthrosis was performed to improve the range of motion. Clinical roentgenographic, radionuclide, and pathologic observations are presented on the formation of a synovial joint within the heterotopic bone.

Adult↗
PubMed1987

High doses of the diphosphonate EHDP for the prevention of heterotopic ossification. An experimental and clinical study.

The effect of Ethane-1-Hydroxyl-1, 1-Diphosphonate (EHDP) on experimental and clinical heterotopic ossification was studied. Demineralized cortical bone matrix was implanted in the abdominal wall of three groups of adult male rats. Two groups received injections amounting to 5 and 20 mg/kg/day of EHDP, respectively, and a control group received placebo. The lower dose of EHDP had no effect on bone formation, whereas the higher dose resulted in a marked reduction in ash content and 45Ca uptake in the implants. Inhibitory effects on heterotopic bone and serum alkaline phosphatase activity were observed when treating with high doses (50 mg/kg/day) a paraplegic patient following resection of para-articular ossifications around the hips. The effect of EHDP on bone formation is interpreted as reflecting a dose-dependent interference with the deposition of hydroxyapatite crystals in the bone matrix.

Adult↗
PubMed1987

Dendriform pulmonary ossification.

Dendriform pulmonary ossification is a rare entity associated with chronic lung disease that is almost invariably discovered as an incidental finding at autopsy. Antemortem chest roentgenograms of patients with dendriform pulmonary ossification are often interpreted as pulmonary fibrosis and/or bronchiectasis. Radiographic and pathologic findings in two cases are described herein.

Aged↗
PubMed1987

Ossification of the spinal ligament. A radiographic reevaluation in Bologna, Italy.

A radiographic reevaluation of cervical spine films of 1,258 adult patients and of thoraco-lumbar spine films of 488 of these was performed at the Rizzoli Orthopaedic Institute (Bologne, Italy), in order to detect ossification of the posterior longitudinal ligament (OPLL), the anterior longitudinal ligament (OALL), the yellow ligament (OYL) and the nuchal ligament at the cervical level, and OPLL, OALL and OYL at the thoraco-lumbar level. The incidence of OALL, OYL and ossification of the nuchal ligament corresponded with those previously reported in the literature. Cervical OPLL was found in 1.83%, with a definite prevalence in the 45-64 age group where the figure was 2.83%. This incidence is much higher than that hitherto reported in Caucasians, and is nearly the same as that in Japan. Possible explanations for this discrepancy are proposed.

Adult↗
PubMed1988

Limited dermal ossification: a case report.

A case is reported of a 10-year-old girl with ossification of the dermis in a limited distribution. The patient has no underlying disorder of calcium or phosphate metabolism and the ectopic bone has been analyzed and found to be identical to normal membranous bone. The ectopic ossification has bridged several of the joints of the patient's upper and lower extremities. At present, the patient is nonambulatory, but has no respiratory or cardiac abnormalities. Her mental status and IQ are normal.

Child↗
PubMed1988

Periarticular heterotopic ossification after total hip arthroplasty for primary coxarthrosis.

Periarticular heterotopic ossification (PHO) is a common roentgenographic finding, occurring in more than two-thirds of patients after total hip arthroplasty (THA) for coxarthrosis. In the present study, 56 patients treated with bilateral THA were analyzed to determine the correlation between heterotopic ossification on the two sides. A strong correlation was found between the grade of PHO on the two sides: patients who developed severe PHO after the first THA invariably developed considerable PHO after surgery on the other side. The incidence and grade of PHO were higher in men than in women.

Age Factors↗