Clinical survey of and pathogenic approach to para-articular ossifications in long-term coma.

1. Thirteen patients with para-articular ossification complicating long-term coma are presented. In a series of 26 patients with long-term coma following cerebral traumatic lesions, seven cases were found with para-articular ossification. 2. The high frequency of elbow involvement is emphasized, and in all these cases posterior ossifications were present. 3. In five patients, ossifications were observed in limbs which were not paralytic and in which integrity of the efferent nerve tracts could be demonstrated. 4. The importance of functional or paralytical immobility and of a completely bedridden condition in the patients is emphasized. 5. The aetiopathogenesis of para-articular ossifications still remains unknown, but a prolonged complete immobilization possibly induces vasomotor, metabolic and trophic disorders, which can give rise to metaplasia.