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( Avadhoot P. Kantak ),( Nirav N. Shah ) 대한고관절학회 2017 Hip and Pelvis Vol.29 No.4
Purpose: One of the local factors contributing to the formation of heterotopic ossification includes bone debris generated during the surgery. This risk can be partially nullified by use of saline wash. Our research aim was to ascertain if extensive intraoperative lavage can reduce the incidence and severity of heterotopic ossification in primary total hip arthroplasty. Materials and Methods: A retrospective case control radiological study of 145 patients (175 hip replacements). The control group received minimal intra-operative lavage (< 1,000 mL); consisted of 90 primary hip replacements. The index group received extensive saline lavage ( >3,000 mL), and included 85 primary hip replacements. Brooker classification was used to grade radiographs at one year for development of heterotopic ossification. Results: Sixty-six patients in control group had heterotopic ossification, with six showing a significant grade (grade 3 or 4). Thirty-five patients in the index group had heterotopic ossification with no incidence of severe grade. Majority patients in the index group showed a predominantly grade 1 heterotopic ossification; 28 out of 35, as compared to 37 out of 66 in control group. There was a statistically significant difference in the incidence (P<0.05) as well as severity of heterotopic ossification between the groups (P<0.05). Conclusion: We conclude that use of extensive lavage during total hip replacement reduces the incidence as well as severity of heterotopic ossification.
Heterotopic Ossification in Pressure Sore; A Case Report
Choi, Yun Seok,Sung, Shin Wee,Yoo, Gyeol 大韓成形外科學會 1999 Archives of Plastic Surgery Vol.26 No.2
There are many complications related to paralyzed patients. Heterotopic ossification in pressure sore patients is reported to be rarely developed, but once it occurs, it frequently causes joint stiffness which may aggrevate the pressure sore wound. This paper was based on a clinical study of heterotrophic ossification in 6 quadriplegic and paraplegic patients from 1988 to 1997 at St. Paul's Hospital. All were males aged between 22 and 58 years (mean age, 45.5 years). The sites of pressure sore were in the ischial and trochanteric areas. Heterotopic ossification had developed around the hip joint and the ischial area. The mean onset time was 3.6 years (minimum 10 months maximum 8 years) after trauma. Plain X-ray, bone scan CT and pathological examination were helpful in confirming the diagnosis of heterotopic ossification. The mechanism of heterotopic ossification is not exactly known, but chronic trauma or inflammation could be one etiology. There are still many difficulties in management of heterotopic ossification, but prevention is the most important treatment.
Yumin Kim,Park Sun-Kyung,김종호 대한창상학회 2022 Journal of Wound Management and Research Vol.18 No.3
Heterotopic ossification is defined as the development of mature bone tissue outside normal bone. Osteomyelitis is an infection-related inflammatory disorder of the bones. Although pressure sores accompanied by heterotopic ossification have been reported, there have been no reports of osteomyelitis occurring in proximity to heterotopic ossification. Herein, we report a rare case of osteomyelitis in heterotopic ossification after trochanteric pressure sore reconstruction. We also emphasize the importance of proper diagnosis and surgical approach for this infected heterotopic ossification lesion.
무산소성 뇌증환자의 이소성 골화증에 대한 빈소산 치험례
김현식,김소연,권소연,제준태,윤채성,성강경,Kim, Hyun-Sik,Kim, So-Yeon,Kwon, So-Yeon,Jae, Jun-Tae,Yun, Chae-Sung,Sung, Kang-Kyeng 대한한의학방제학회 2009 大韓韓醫學方劑學會誌 Vol.17 No.2
Heterotopic ossification is often complicated in patients with brain injury. It occurs in the connective tissue of skeletal muscle close to a joint, especially most highly in the hip joint. This study have reported a case of heterotopic ossification in hypoxic brain damage patient due to cardiac attack. Binso-san is known by medication on arthritis. It has an effect on pain control or reduce of swelling in the joints. This study suggest that Binso-san has an improving effect on hip joint affected by Heterotopic ossification.
Heterotopic mesenteric ossification: a report of two cases
Hisham F. Bahmad,Olga Lopez,Tyson Sutherland,Marisa Vinas,Kfir Ben-David,Lydia Howard,Robert Poppiti,Sarah Alghamdi 대한병리학회 2022 Journal of Pathology and Translational Medicine Vol.56 No.5
Heterotopic mesenteric ossification (HMO) is abnormal bone formation in tissues which usually do not undergo ossification. There are approximately 75 cases reported worldwide. We present two cases of HMO. The first case is that of a 39-year-old man who presented with abdominal pain and a computerized tomography scan of the abdomen and pelvis revealed an apple core lesion resulting in small bowel obstruction. The second case is that of a 36-year-old woman who presented 2 months after undergoing robotic gastric sleeve resection complaining of weakness and emesis. An esophagogram revealed kinking at the distal esophagus. Surgical resection was performed in both, yielding the diagnosis of HMO. There are various theories as to the pathophysiology of HMO, but no clearly defined mechanism has been established. Management should be conservative whenever possible to prevent further ossification with subsequent surgical intervention.
Heterotopic Ossification of the Xiphoid Process after Abdominal Surgery for Traumatic Hemoperitoneum
홍승표,이진배,배지훈 대한의학회 2018 Journal of Korean medical science Vol.33 No.7
Heterotopic ossification of the xiphoid process is extremely rare, with only three cases previously reported. However, the surgical pathology for postoperative elongation of the xiphoid process after abdominal surgery has not yet been reported. We report a case of the postoperative elongation of the xiphoid process, 8 years after abdominal surgery for traumatic hemoperitoneum in a 53-year-old man. The patient underwent surgical excisio of the elongated mass of the xiphoid process. Histopathology revealed multiple exostoses Heterotopic ossification can occur after surgical trauma to soft or bone tissue. Surgical excision with primary closure is the treatment of choice for symptomatic heterotopic ossification.
이소성 골형성으로 인한 주관절 강직에서 12개월 이내에 시행한 수술적 치료의 효과
김용민(Yong-Min Kim),박지강(Ji-Kang Park),정수리(Suri Chong) 대한정형외과학회 2014 대한정형외과학회지 Vol.49 No.6
이소성 골형성으로 인해 주관절 운동 제한이 발생한 5예에 대해 1년 이내에 수술적 치료를 시행하였다. 수상 시로부터 평균 10개월에 수술적 치료로 이소성 골제거술 및 관절 유리술을 시행하였고 방사선 요법은 700 cGy로 1회 시행하였다. 비스테로이드성 소염제는 평균 4주간 사용하였다. 평균 21개월의 추적관찰 기간 중 이소성 골형성의 재발은 발생하지 않았다. 최종 추시에는 굴곡-신전 운동의 범위가 평균 64도에서 133도로 증가하였다. 이소성 골형성으로 인한 주관절의 운동제한이 발생한 경우 수상 시로부터 수술 시점은 기존에 제시되던 12-18개월보다 적은 1년 이내라도 방사선 치료 및 비스테로이드성 소염제를 동반한 수술적 치료로 효과적인 결과를 얻을 수 있었다. Five patients presented with a limited range of motion in their elbow associated with heterotopic ossification. All of these patients underwent surgery within one year. Removal of heterotopic ossification and a posterior capsular release was performed within ten months on average after the initial injury. Each patient postoperatively received prophylaxis consisting of a single-shot radiation of 700 cGY and administration of nonsteroidal anti-inflammatory drugs (NSAIDs) for four weeks on average. With a median follow up period of 21 months, five patients had no radiographic evidence of recurrence. The arc of flexion-extension increased from an average of 64 degrees preoperatively to 133 degrees at the latest follow up. A 12- to 18-month period is generally recommended as necessary for an operation on an ankylosed elbow associated with heterotopic ossification. However, the operative treatment, together with radiation therapy and NSAIDs administration, showed good results within 12 months.
Jae-Sung Yoo,Seung-Kwan Park,Joong-Bae Seo 대한정형외과 스포츠의학회 2018 Arthroscopy and Orthopedic Sports Medicine Vol.5 No.2
Intra-tendinous calcification of the rotator cuff is a rare condition usually associated with heterotopic ossification. In particular, heterotopic ossification within the subscapularis tendon is very rare and little is known about its etiology and the mechanisms underlying its pathogenesis. Here, we describe a patient complaining of pain in his right anterior shoulder. Radiographic evaluation revealed a significant ossifying mass entrapped in the subscapularis tendon with tendon thinning. We duly performed open excision of the heterotopic ossification and open repair of the rotator cuff. Six months later, the subscapularis tendon had healed and the symptoms had disappeared.