Global Excision of Severe Heterotopic Ossification of the Shoulder: A Case Report. Issue 1 (January 2020)

• Record Type: Journal Article
• Authors: Polfer, Elizabeth M.; Nappo, Kyle E.; Giuliani, Jeffrey R.; Nesti, Leon J.
• Is Part Of: JBJS case connector. Volume 10:Issue 1(2020)
• Publication Date: 2020-01
• Subjects: Orthopedic surgery -- Case studies -- Periodicals; Orthopedic surgery -- Periodicals; Orthopedics; Orthopedic Procedures; Orthopedic surgery; Periodicals; Electronic journals; Case studies; Periodicals; 616.7
• DOI: 10.2106/JBJS.CC.18.00080
• Languages: English
• ISSNs: 2160-3251

Abstract

Abstract : 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.