Mendelson L, Grosswasser Z, Najenson T, Sandbank U, Solzi P
Scand J Rehabil Med. 1975;7(4):141-5.
A total of 35 cases of periarticular new bone formation (PNBF) was observed among 160 patients with coma following severe craniocerebral trauma. All cases were associated with blunt trauma and none with penetrating wounds. Only 6 of 500 cases of acute non-traumatic hemiplegia developed PNBR, and all 6 of them followed craniotomy, brain surgery and coma. New bone formation first appeared mainly between 50 and 120 days after craniocerebral injury with prolonged coma. Three-quarters of the patients with PNBF showed involvement of the shoulder joint, but this was not associated with previous subluxation. Metabolic studies were done in some patients; no disturbances were found in the metabolism of calcium, phosphorus or alkaline phosphatase. The pathologic process of PNBF seemed to stabilize some 6 to 8 months following trauma, and surgery after this period produced functional improvement in the 3 patients in whom it was tried. No satisfactory pathophysiological explanation has been found for the phenomenon of PNBR. Prolonged coma is common to all patients who suffered from PNBF and is probably an etiologic factor. The absence of PNBF in cases of cerebrovascular accident with subluxations of the gleno-humeral joint and intensive physiotherapy seems to contradict the suggestion of microtrauma as an etiological factor.
在160例重度颅脑创伤后昏迷的患者中，共观察到35例关节周围新骨形成（PNBF）。所有病例均与钝性创伤有关，无一例与穿透性伤口有关。在500例急性非创伤性偏瘫患者中，只有6例发生了PNBR，且这6例均在开颅手术、脑部手术后出现昏迷。新骨形成主要在颅脑损伤伴长期昏迷后50至120天首次出现。四分之三的PNBF患者肩关节受累，但这与既往半脱位无关。对部分患者进行了代谢研究；未发现钙、磷或碱性磷酸酶代谢紊乱。PNBF的病理过程在创伤后约6至8个月似乎趋于稳定，在此期间后进行手术的3例患者功能得到改善。对于PNBR现象，尚未找到令人满意的病理生理学解释。长期昏迷是所有发生PNBF患者的共同特征，可能是一个病因。在伴有肩肱关节半脱位和强化物理治疗的脑血管意外病例中未出现PNBF，这似乎与微创伤作为病因的观点相矛盾。
