全球切除严重异位骨化的肩膀：案例报告。
Global Excision of Severe Heterotopic Ossification of the Shoulder: A Case Report.
机构信息
Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, Maryland.
Department of Orthopaedics, Walter Reed National Military Medical Center, Bethesda, Maryland.
出版信息
JBJS Case Connect. 2020 Jan-Mar;10(1):e0080. doi: 10.2106/JBJS.CC.18.00080.
CASE
A 21-year-old man sustained a closed glenohumeral fracture/dislocation as a pedestrian struck by a motor vehicle. He was treated nonoperatively and developed severe post-traumatic heterotopic ossification (HO) with near-complete shoulder ankylosis. We present our technique for safe surgical excision.
CONCLUSIONS
Excision led to improvements in motion and quality of life at 1 year postoperatively. Recommendations for successful HO excision around the shoulder include excision after at least 180 days, appropriate preoperative imaging to include cross-sectional imaging and a 3D model, intraoperative fluoroscopy, well-serviced instruments, preparation for iatrogenic fracture and/or neurovascular injury, meticulous hemostasis, postoperative HO prophylaxis, immediate postoperative therapy, and involvement of a multidisciplinary team.
病例
一名 21 岁男性作为行人被机动车撞击，导致闭合性盂肱关节骨折/脱位。他接受了非手术治疗，但随后发展为严重的创伤后异位骨化（HO），导致肩关节几乎完全僵硬。我们介绍了一种安全的手术切除技术。
结论
手术后 1 年，运动功能和生活质量均得到改善。关于肩关节 HO 切除成功的建议包括至少 180 天后进行切除、适当的术前影像学检查（包括横断面成像和 3D 模型）、术中透视、服务良好的器械、针对医源性骨折和/或神经血管损伤的准备、精细的止血、术后 HO 预防、即刻术后治疗以及多学科团队的参与。
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