11/165. Osseous overgrowth after post-traumatic amputation of the lower extremity in childhood.Severe accidents in children may cause extreme destruction of the lower extremities. In some cases, there is no possibility to preserve the limbs. Initially, a weight-bearing stump cannot be achieved after amputation due to unstable local and soft tissue conditions. This critical situation is often complicated by one of the leading problems in the limb-deficient child - the development of osseous overgrowth. Bizarre overgrowth of the stump may lead to skin perforation, pressure ulcers, and difficulties with the prosthesis. Since 1993, we have been able to follow five pediatric and adolescent patients (2 years to 17 years old) with six post-traumatic amputations of the lower extremities. Four of these cases developed osseous overgrowth. One child treated with initial autologous stump-capping had excellent soft tissue conditions and no problems with the artificial limb. We also report on a case of bizarre and extensive new bone formation. We conclude that close follow-up visits after post-traumatic amputations in children are essential because of new bone formation which may endanger the soft tissue situation of the stump. Unfortunately, surgical revisions have to be performed quite often. To avoid several surgical corrections, an initial stump-capping with autologous material from the injured limb can be performed. Thus, the number of secondary procedures may be reduced drastically.- - - - - - - - - - ranking = 1keywords = trauma (Clic here for more details about this article) |
12/165. radiation therapy for heterotopic ossification in a patient with traumatic brain injury.radiation therapy has been known to have a prophylactic effect for heterotopic ossification (HO), but until now it has not been known to have a therapeutic effect for established HO. We report a case of established HO compounded with a sudden increase in activity, that was improved with radiation therapy. A patient with traumatic brain injury had HO in both hips and thighs two months after the initial trauma. The existing level of HO activity suddenly increased seven months after the initial trauma, and was accompanied by severe pain that was refractory to indomethacin. We assumed that the pain was caused by the increased activity of HO on the basis of clinical symptoms and laboratory results. Initially, the patient received radiation therapy to the left lower extremity, with a total dose of 20 Gy in ten fractions. Next, the patient received radiation therapy at the same dosage to the right lower extremity, after which the pain and level of serum alkaline phosphatase significantly decreased. The patient experienced a mild pancytopenia as a side effect of the radiation therapy, but it was not severe enough to stop the radiation therapy, given the patient's suffering from the increased HO activity.- - - - - - - - - - ranking = 130.17309685928keywords = traumatic brain injury, brain injury, traumatic brain, injury, brain, trauma (Clic here for more details about this article) |
13/165. Heterotopic ossification of the adductor longus muscle presenting as dyspareunia.dyspareunia after heterotopic ossification of the adductor longus is a rare complication. We describe a patient with symptomatic heterotopic ossification of the adductor muscle that developed years after sustaining a fracture of the inferior pubic ramus in association with an injury to the adductor longus muscle. The patient's pain was reduced and his dyspareunia resolved after excision of the adductor longus heterotopic ossification and subsequent physical therapy.- - - - - - - - - - ranking = 3.4818314289149keywords = injury (Clic here for more details about this article) |
14/165. The surgical treatment of heterotopic ossification at the elbow following long-term coma.Nine cases of heterotopic ossification at the elbow in seven patients who had a cerebral injury and prolonged coma were treated by excision of the extra-articular bone bridge from the humerus to the ulna. The bridge was either anterior or posterior, and did not involve the radius. The articular cartilage in all elbows showed no significant evidence of degeneration in spite of the prolonged immobility of the joints during the period of coma. Two of the patients also had resection of heterotopic bone about the hip joint which resulted in rapid reformation of bone. In all patients there was restoration of satisfactory function in the elbow operated on without reformation of bone. Follow-up was from ten months to 8.7 years.- - - - - - - - - - ranking = 3.4818314289149keywords = injury (Clic here for more details about this article) |
15/165. Bilateral ossification in the achilles tendon: a case report.Bilateral symmetrical achilles tendon ossification is presented, with a fracture on one side. A 57 year old male patient was conservatively treated for bilateral clubfeet in his childhood. Part of his Achilles tendons were replaced by ectopic bony mass and on the left it fractured without any trauma. The fracture was treated surgically by vertical thinning, intraosseal suture "osteosynthesis", and tendon flap plasty. This pathological condition healed in three months. Seven years after the operation the X-ray revealed total bony rebuilding. The ectopic bone mass has the same biological behaviour as the anatomic bones.- - - - - - - - - - ranking = 0.16666666666667keywords = trauma (Clic here for more details about this article) |
16/165. Antegrade intramedullary nailing of the humerus complicated by heterotopic ossification of the deltoid: a case report.A case of antegrade nailing of the humeral shaft in a polytrauma patient was complicated by heterotopic ossification of the lateral deltoid muscle and severe loss of shoulder motion. The patient did not respond to physiotherapy alone and was successfully managed by excision of the heterotopic bone and adjunctive radiation therapy.- - - - - - - - - - ranking = 0.16666666666667keywords = trauma (Clic here for more details about this article) |
17/165. Bone-like tissue growth in the root canal of immature permanent teeth after traumatic injuries.Following a severe traumatic incident to permanent immature teeth, the growth of calcified tissue in the pulp space may occasionally occur. This calcified tissue may be diffuse or in intimate contact with the dentine. It has been suggested that a wide open apex, severe damage to the root sheath, and the absence of infection are only some of the predisposing factors leading to this metaplasia of pulp tissue into bone-like tissue. Five cases are described.- - - - - - - - - - ranking = 0.83333333333333keywords = trauma (Clic here for more details about this article) |
18/165. Formation of a bone and joint following blunt injury to the pelvis.The formation of a new bone from the lateral wall of the pelvis following blunt injury occurred in a 55-year-old woman. The bone articulated with the top of the trochanter by means of a synovial-lined joint. The case is an example of the remarkable ability of external forces to remodel newly formed bone into a functional architectural unit and to produce an accessory pseudojoint.- - - - - - - - - - ranking = 17.409157144574keywords = injury (Clic here for more details about this article) |
19/165. Slit-ventricle syndrome secondary to shunt-induced suture ossification.OBJECTIVE: To report five children with slit-ventricle syndrome who were found to have increased intracranial pressure despite functioning cerebrospinal fluid shunts. methods: Computed tomographic scans demonstrated erosion of the inner table of the cranium and sclerosis of the cranial sutures, particularly the coronal suture. magnetic resonance imaging scans demonstrated no cerebrospinal fluid over the convexities. The patients were treated with cranial expansion operations that included removal of the sclerotic sutures, which were examined histologically. RESULTS: Postoperatively, symptoms resolved for all children. Sutures were abnormal and contained foci of cartilage and bone within abnormally arranged fibrous tissue. CONCLUSION: We postulate that chronic overdrainage of cerebrospinal fluid via shunts dampens the normal cerebral pressure waves; growth of the calvarium is thus understimulated, and this leads to ossification of the sutures, which become unable to expand to allow normal brain growth. Shunt-induced craniostenosis should be considered for children with symptoms of slit-ventricle syndrome for whom shunts are functional but intracranial pressure is increased. Cranial expansion operations may be more appropriate treatments than subtemporal decompressions for such children, given the diffuseness of the suture pathological features.- - - - - - - - - - ranking = 0.58267295221385keywords = brain (Clic here for more details about this article) |
20/165. Fractured heterotopic bone in myositis ossificans traumatica.OBJECTIVE: To discuss the case of a patient with an acute fracture occurring through preexisting, quiescent, posttraumatic heterotopic bone formation of the gastrocnemius muscle. The lesion demonstrated a previously unreported pattern of healing. This case serves to demonstrate an infrequent event with a rare and heretofore unreported sequella. Clinical Features: A 54-year-old man with preexisting, mature heterotopic bone within the left gastrocnemius muscle experienced reinjury to the site. The preexisting heterotopic bone was a result of a sporting injury that had occurred 32 years previously. At the time of the new injury, the patient experienced immediate, severe pain. Radiographs demonstrated a nondisplaced oblique fracture through the preexisting heterotopic bone. Intervention and Outcome: The patient was treated with protective wrapping and physiotherapy modalities. Because only the heterotopic bone was involved, the leg was not placed in a cast. Follow-up radiographs obtained 14 weeks later showed callus formation about the fractured site and evidence of union. CONCLUSION: Fractures occurring through mature heterotopic bone formations, such as those seen in myositis ossificans traumatica, are infrequent; callus formation with union of the fractured fragments is an even rarer occurrence.- - - - - - - - - - ranking = 11.445494286745keywords = injury, trauma (Clic here for more details about this article) |
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