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Therapeutic strategies for elbow ankylosis due to heterotopic ossification in patients with severe burns

BACKGROUND: Heterotopic ossification (HO) occurs frequently in the elbow in burn patients, and extends beyond the anatomical structure. HO of the elbow can cause joint contracture and adversely affect activities of daily living. Currently, there is no effective prophylaxis for HO as the precise unde...

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Autores principales: Suito, Motomu, Yuzuriha, Shunsuke, Iwasawa, Motonao, Yanagisawa, Daisuke, Kinjo, Yuto, Takashimizu, Ikkei, Hoshino, Yuki
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7061606/
https://www.ncbi.nlm.nih.gov/pubmed/32158828
http://dx.doi.org/10.1016/j.jpra.2018.06.004
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author Suito, Motomu
Yuzuriha, Shunsuke
Iwasawa, Motonao
Yanagisawa, Daisuke
Kinjo, Yuto
Takashimizu, Ikkei
Hoshino, Yuki
author_facet Suito, Motomu
Yuzuriha, Shunsuke
Iwasawa, Motonao
Yanagisawa, Daisuke
Kinjo, Yuto
Takashimizu, Ikkei
Hoshino, Yuki
author_sort Suito, Motomu
collection PubMed
description BACKGROUND: Heterotopic ossification (HO) occurs frequently in the elbow in burn patients, and extends beyond the anatomical structure. HO of the elbow can cause joint contracture and adversely affect activities of daily living. Currently, there is no effective prophylaxis for HO as the precise underlying mechanism remains unknown. Therefore, there is no choice but to treat HO after it has developed. To date, however, no effective standard treatment has been reported, and therefore treatment methods vary between different facilities. Surgical resection is widely accepted as the only therapeutic option once HO limits functional mobility of the elbow. PURPOSES: Based on past reports, we examined our cases and recommend effective therapeutic strategies. We posed the following three questions: (1) Is the surgical intervention effective or detrimental for elbow ankylosis due to HO? (2) What is the best timing for the intervention? (3) What is the most effective postoperative rehabilitation plan? METHODS: We treated three patients with complete ankylosis of the elbow due to HO after severe burn injury using different protocols. RESULTS: Surgery was performed in two cases and rehabilitation therapy was commenced immediately from the first postoperative day. Both patients showed improvement in the active range of motion in their elbow joints. The other patient did not undergo surgery, and his elbows became fixed in the completely extension position. CONCLUSION: Surgical resection is beneficial for elbow ankylosis due to HO after burn injury. Although the exact surgical timing is still controversial, we recommend that surgery should be performed as soon as possible after improving the skin condition around the elbow and confirming the maturation of HO on radiographs. Early rehabilitation and pain control are also important after surgery.
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spelling pubmed-70616062020-03-10 Therapeutic strategies for elbow ankylosis due to heterotopic ossification in patients with severe burns Suito, Motomu Yuzuriha, Shunsuke Iwasawa, Motonao Yanagisawa, Daisuke Kinjo, Yuto Takashimizu, Ikkei Hoshino, Yuki JPRAS Open Case Reports and Short Communication BACKGROUND: Heterotopic ossification (HO) occurs frequently in the elbow in burn patients, and extends beyond the anatomical structure. HO of the elbow can cause joint contracture and adversely affect activities of daily living. Currently, there is no effective prophylaxis for HO as the precise underlying mechanism remains unknown. Therefore, there is no choice but to treat HO after it has developed. To date, however, no effective standard treatment has been reported, and therefore treatment methods vary between different facilities. Surgical resection is widely accepted as the only therapeutic option once HO limits functional mobility of the elbow. PURPOSES: Based on past reports, we examined our cases and recommend effective therapeutic strategies. We posed the following three questions: (1) Is the surgical intervention effective or detrimental for elbow ankylosis due to HO? (2) What is the best timing for the intervention? (3) What is the most effective postoperative rehabilitation plan? METHODS: We treated three patients with complete ankylosis of the elbow due to HO after severe burn injury using different protocols. RESULTS: Surgery was performed in two cases and rehabilitation therapy was commenced immediately from the first postoperative day. Both patients showed improvement in the active range of motion in their elbow joints. The other patient did not undergo surgery, and his elbows became fixed in the completely extension position. CONCLUSION: Surgical resection is beneficial for elbow ankylosis due to HO after burn injury. Although the exact surgical timing is still controversial, we recommend that surgery should be performed as soon as possible after improving the skin condition around the elbow and confirming the maturation of HO on radiographs. Early rehabilitation and pain control are also important after surgery. Elsevier 2018-07-05 /pmc/articles/PMC7061606/ /pubmed/32158828 http://dx.doi.org/10.1016/j.jpra.2018.06.004 Text en © 2018 The Authors http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Case Reports and Short Communication
Suito, Motomu
Yuzuriha, Shunsuke
Iwasawa, Motonao
Yanagisawa, Daisuke
Kinjo, Yuto
Takashimizu, Ikkei
Hoshino, Yuki
Therapeutic strategies for elbow ankylosis due to heterotopic ossification in patients with severe burns
title Therapeutic strategies for elbow ankylosis due to heterotopic ossification in patients with severe burns
title_full Therapeutic strategies for elbow ankylosis due to heterotopic ossification in patients with severe burns
title_fullStr Therapeutic strategies for elbow ankylosis due to heterotopic ossification in patients with severe burns
title_full_unstemmed Therapeutic strategies for elbow ankylosis due to heterotopic ossification in patients with severe burns
title_short Therapeutic strategies for elbow ankylosis due to heterotopic ossification in patients with severe burns
title_sort therapeutic strategies for elbow ankylosis due to heterotopic ossification in patients with severe burns
topic Case Reports and Short Communication
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7061606/
https://www.ncbi.nlm.nih.gov/pubmed/32158828
http://dx.doi.org/10.1016/j.jpra.2018.06.004
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