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PubMed1985

Resection of heterotopic ossification in the adult with head trauma.

Lesions of heterotopic ossification were excised from thirty-seven joints in twenty-three adults who had had injuries to the brain. The lesions were excised from twenty-three elbows, twelve hips, and two shoulders. Patients were retrospectively divided into five categories according to the neural residua (cognitive and physical deficits). The patients in Class I (minimum cognitive and physical disability) and patients in Class II (minimum cognitive disability and moderate physical disability) who had fair or good selective control of the affected extremity had the best prognosis for maintaining the range of motion resulting from resecting the lesion and improving function postoperatively. They also had a low incidence of recurrence of the lesion. Seven of the nine elbows and eight of the eight hips in patients in these classes had successful results. All three of the patients in Class V (severe cognitive and physical deficits) who had a lesion of the hip and all eight of the patients in Class V with poor selective control had a poor result. In the twenty-five joints for which adequate follow-up radiographs were available to determine if the lesion recurred, fourteen recurrences were identified (56 per cent). Eleven of these patients were considered to have a poor result. Nine of the fourteen recurrences occurred in patients in Class V. Radiographic evidence of the maturity of the lesion and a normal level of alkaline phosphatase were of limited importance in predicting a low rate of recurrence. The over-all complications included four superficial infections and no instances of osteomyelitis.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1977

Diffuse pulmonary ossification.

Diffuse pulmonary ossification (DPO) was a complication of "shock lung" after aortic valve replacement in a 52-year-old man. The relationship of DPO to shock lung is discussed. A possible mechanism for this complication is based on the development of a fibrin-platelet-fibroblastic interaction that may establish an intraalveolar lattice for collagen deposition by the fibroblast. The development of acidosis and mechanical forcer may potentiate fibroblastic transformation into an osteoblast. The mechanical forcer may influence the shape of the bone in the lung.

Aortic Valve↗
PubMed1977

Ectopic ossification.

Ectopic ossification is a biologic process in which new bone is formed in tissues which normally do not ossify. Three cases of this disease are described. The literature on this subject has been extensively analysed and organized. Classification, etiology, clinical and radiological features and laboratory tests are discussed. The paper also discusses the histopathology, differential diagnosis and management of this disease.

Adult↗
PubMed1977

[Periarticular ossification following severe brain injury].

A particular ossification should be considered besides primary neurological causes, if there are functional restrictions of the joint movements after severe head trauma. New bone formation has been seen extending from the periarticular tissue. The problems of the new bone formation in both hip-joints are shown in a patient with traumatic apallic syndrome. After exact indication and with careful and atraumatic operative technique functional restitution of the joints can be achieved without danger of recurrence.

Adult↗
PubMed1983

Disodium etidronate: its role in preventing heterotopic ossification in severe head injury.

Heterotopic ossification (HO) occurs in up to 75% of patients who survive severe head injury and is a major factor in prolonging their rehabilitation. Prevention of HO has not been emphasized in acute care management of patients with head injury. But with spinal cord injuries and total hip arthroplasty, HO has been prevented by use of disodium etidronate (EHDP). This study compares the incidence and severity of HO in 10 patients with severe head injury who were treated with EHDP and 10 matched controls without drug treatment. Patients selected for EHDP treatment were consecutive admissions who had Glasgow Coma Scores (GCS) less than nine. Treatment was begun within two to seven days of injury with 20mg/kg/day via nasogastric tube and was discontinued if the patient awakened within two weeks (low risk of HO). After three months EHDP was given orally at 10mg/kg/day for an additional three months. Ten patients completed the treatment regime and were compared to 10 patients with similar injuries. Of the 10 patients treated with EHDP, two developed HO, while clinically significant HO was found in seven of the 10 nontreated patients (chi square = p less than 0.025). This finding could not be explained on the basis of differences in the two groups; the groups were alike in age, sex, length of coma, extracranial fracture, spasticity, type of head injury, and injury severity (GCS). These data suggest that HO may be prevented by early use of EHDP, and the results warrant further clinical trials.

Adolescent↗
PubMed1983

[Heterotopic ossification in the skeletal muscle metastases of advanced stomach cancer].

The formation of heterotopic bone tissue in carcinomas of the gastrointestinal tract and/or their metastases is extremely rare. In a 74-year-old female with gastric adenocarcinoma, we observed extensive bone formation within metastases in the skeletal muscles. There are only 7 other cases of heterotopic bone formation in gastric cancer reported in the world literature. We suggest that heterotopic ossification in primary cancers and/or their metastases is probably the result of metaplasia of stromal fibroblasts into osteoblasts.

Adenocarcinoma↗
PubMed1983

Bilateral diffuse pulmonary ectopic ossification after marrow allograft in a dog. Evidence for allotransplantation of hemopoietic and mesenchymal stem cells.

In light of recent studies showing successful transplantation of both bony and stromal elements by marrow transplantation, we report an unexpected phenomenon occurring in a canine radiation chimera. Nine hundred fifty-six days after a successful and uneventful DLA-matched marrow allograft, a dog suddenly died of respiratory failure. Autopsy revealed extensive ossification of the lungs with multiple sites of trilineage marrow engraftment. The entire complement of bony elements can apparently be allografted using marrow grafting techniques.

Animals↗
PubMed1983

Heterotopic ossification heralded by a knee effusion.

A knee effusion suddenly appeared in a 44-year-old woman one month after she suffered a neurological catastrophe. Heterotopic ossification (HO) subsequently developed above her knee. Because treatment of HO with disodium etidronate may be successful if started early, awareness of the association between acute arthritis and new bone formation in certain clinical settings is important.

Adult↗
PubMed1983

Subtotal ossification of the Achilles tendon. Case report.

The authors describe a case of subtotal ossification of the Achilles tendon in which the affected portion of the tendon was excised and replaced by reflecting down a portion of the distal aponeurotic tendon of the gastrocemius. The good result obtained shows that this is a valid method of treatment despite the large gap in the Achilles tendon after resecting the ossified portion.

Achilles Tendon↗
PubMed1984

[Osteogenic metaplasia or residual embryonic endometrial ossification?].

There are only about 90 cases described in the literature of the presence of an intra-uterine osseous structure--so the condition is not a common one. Often the aetiology is unknown. The purpose of this work is to describe the clinical picture and the anatomo-pathological characteristics on one form which leaves practically no doubt as to how the presence of bony structures in the uterus arise. We call this residual endometrial-ossification (O.R.E.) and note osteogenic or osseous metaplasia. We define O.R.E. as the presence of an osseous structure inside the uterus which does not arise from metaplasia of the cells of the endometrium.

Abortion, Legal↗
PubMed1984

[Sternum-splitting approach for ossification of the posterior longitudinal ligament in the cervico-thoracic junction].

In this paper the author reported an operative approach for ossification of the posterior longitudinal ligament (OPLL) of the lower cervical and upper thoracic vertebrae. There are two types of surgery for OPLL, namely, posterior and anterior approaches. As a rule, we utilize an anterior approach for OPLL. Recently we performed a modified sternum-splitting approach in surgery for OPLL in the cervico-thoracic junction. In the original trans-sternal approach introduced by Cauchoix, the sternum is split from the suprasternal notch to the xiphoid process. We cut the manubrium only. However, a satisfactory exposure of the cervico-thoracic vertebrae down to the third thoracic level was obtained. After reaching the anterior surface of the cervico-thoracic vertebrae, the central portion of the vertebral body and the ossified lesion between the lower one third of the C7 vertebral body and the upper one third of the Th3 vertebral body were removed with an air-drill under an operating microscope. The longitudinal bone defect of the vertebral bodies was filled with a bone graft obtained from the iliac bone. Removal of the ossified lesion in the cervico-thoracic junction can be performed safely by utilizing the modified sternum-splitting approach. This approach can be applied also to endarterectomies at the origins of the vertebral arteries and the right subclavian artery.

Cervical Vertebrae↗
PubMedDate not supplied

[Ossification of the posterior longitudinal ligament].

Two asymptomatic, unusually young male patients aged 18 and 21 with ossification of the longitudinal posterior ligament of the cervical spine are presented. Geographical distribution, pathological and radiologic aspects of the disease are discussed together with those signs differentiating it from ankylosing spinal hyperostosis.

Adolescent↗
PubMed1980

[Comparative roentgenographical study on the incidence of ossification of the posterior longitudinal ligament and other degenerative changes of the cervical spine among Japanese, Koreans, Americans and Germans (author's transl)].

Ossification of the posterior longitudinal liagment (OPLL) of the cervical spine which causes narrowing of the spinal canal has been reported to occur in about three percent of adult Japanese, whereas only sporadical cases have been reported outside Japan. Whether this indicates a real ethnic difference of the disease incidence or simply reflects a difference of attention toward this disease has been one of the questions raised by many workers. In order to clarify this, the author reviewed a large number of roentgenograms of the cervical spine in Japan (Juntendo University Hospital), Korea (Sebrance Hospital and Hanko Sacred Heart Hospital), the United States (Mayo Clinic and Dr. Cloward's Office in Hawaii), and West Germany (Mainz University Hospital). The rate of appearance of OPLL was compared between these ethnic groups. In addition to this, the rate of appearance of calcification of the nuchal ligament and other degenerative changes of the cervical spine such as osteophyte formation and narrowing of the intervertebral disc space was also studied and statistically analysed. Results 1. OPLL: The author found OPLL in 143 out of 6,994 (2.06%) Japanese individuals above 20 years of age. The incidence was lower in Koreans being 0.95%. This was much more pronounced and significant in the United States (Mayo Clinic) and in Germany, where only a few cases were found (Table 6). However, it is interesting to note that six cases found at Dr. Cloward's office in Hawaii included two Japanese. The author concludes that the incidence of OPLL is significantly higher in Japanese than in Caucasians, although the reason for this still remains to be studied. 2. Calcification of the nuchal ligament: This calcification (Barsony) was found in 10.2% among Japanese and in 11.3% among Koreans, whereas in 6.1% among Americans and in 4.5% among GErmans (Table 13). The author proposes that this significantly higher incidence of this calcification among Japanese and Koreans may have something to do with the higher incidence of OPLL in these two countries. 3. Osteophyte: In Japanese and Koreans, the most frequent site of the osteophyte formation was at C-5 between the third and the sixth decades, and then moved to C-6 above 60 years of age, whereas in Americans and Germans, C-6 was the most common site throughout the ages. Although severe osteophytes were found even in younger age group in Japanese and Koreans, the severity of the osteophytes tend to increase comparatively more with age in Americans and Germans. 4. Narrowing of the intervertebral disc space: The narrowing was the most frequent in C-5-6 interspace regardless the age and the ethnic background.

Adult↗
PubMed1980

[Ossification of the posterior longitudinal ligament].

The authors report 4 cases of ossification of the posterior vertebral ligament. In 3 cases, the cervical spine was involved (mainly C4-C6), two included thoracic lesions. Three cases showed signs of spinal cord compression. Only one case was operated on. The authors review the literature. The authors discuss the classification, and the etiology, together with the possible relationship between the disease and ankylosing hyperostosis. Finally the pathogenesis is studied: the authors believe that spinal ischemia plays a very important role.

Adult↗
PubMed1980

[Heterotopic ossification in the site of a surgical scar].

The pathogenesis and clinical picture of heterotopic ossification at a surgical scar location are discussed on the basis of the information reported in the most recent literature and personal series observed in one year in a surgery department. Stress is laid on the importance of the metaplastic process in the development of this picture, its benign nature, the nearly total lack of recurrences and the need for correct differential diagnosis, particularly as regards tumoural metastases.

Adult↗
PubMed1981

Ossification defects and craniofacial morphology in incomplete forms of mandibulofacial dysostosis. A description of two dry skulls.

The morphology of two East Indian dry skulls exhibiting anomalies which were suggested to represent incomplete forms of mandibulofacial dysostosis is described. Obvious although minor ossification anomalies were found localized to the temporal, sphenoid, the zygomatic, the maxillary and the mandibular bones. The observations substantiate the concept of the regional and bilateral nature of the malformation syndrome. Bilateral orbital deviations, hypoplasia of the malar bones, and incomplete zygomatic arches appear to be hard tissue aberrations which may be helpful in examination for subclinical carrier status. Changes in mandibular morphology seem to be less distinguishing features in incomplete or abortive types of mandibulofacial dysostosis.

Adult↗