Global Excision of Severe Heterotopic Ossification of the Shoulder: A Case Report

Elizabeth M. Polfer; Kyle E. Nappo; Jeffrey R. Giuliani; Leon Nesti

doi:10.2106/JBJS.CC.18.00080

Global Excision of Severe Heterotopic Ossification of the Shoulder: A Case Report

Elizabeth M. Polfer, Kyle E. Nappo^*, Jeffrey R. Giuliani, Leon Nesti

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

5 Scopus citations

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.

Original language	English
Pages (from-to)	E0080
Journal	JBJS Case Connector
Volume	10
Issue number	1
DOIs	https://doi.org/10.2106/JBJS.CC.18.00080
State	Published - 19 Feb 2020

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title = "Global Excision of Severe Heterotopic Ossification of the Shoulder: A Case Report",

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.",

author = "Polfer, {Elizabeth M.} and Nappo, {Kyle E.} and Giuliani, {Jeffrey R.} and Leon Nesti",

note = "Publisher Copyright: {\textcopyright} 2020 by the Journal of Bone and Joint Surgery, Incorporated.",

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doi = "10.2106/JBJS.CC.18.00080",

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T1 - Global Excision of Severe Heterotopic Ossification of the Shoulder

T2 - A Case Report

AU - Polfer, Elizabeth M.

AU - Nappo, Kyle E.

AU - Giuliani, Jeffrey R.

AU - Nesti, Leon

PY - 2020/2/19

Y1 - 2020/2/19

N2 - 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.

AB - 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.

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Global Excision of Severe Heterotopic Ossification of the Shoulder: A Case Report

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