heterotrophic ossification of elbow

[Janice]

never said I was a physiotherapist. I am an occupational therapist and have been working in the outpatient field for 10 yrs. I simply asked a question regarding HO, not about manual therapy. If you will re-read my thread i acknowledged why he was having pain and numbness. the MD said there was HO around the shoulder of the prothesis and he felt like this was limiting movement. I feel like the MD is very knowledgable as he is the president of the American Orthopaedic Society for Sports Medicine, authored several books, and many other credientals. I simply wanted some other medical opinion about HO and the nature of it. Cheers, janice

[emad]

Well ;

As for HO , i think it is easy for you to collect reliable knowledge regarding from Internet just search for up to date articles in PDF you will find much .

Just i searched quickly to find out the following :
http://www.jaaos.org/cgi/content/abstract/12/2/116
http://www.emedicine.com/radio/topic336.htm

from 2006 http://www.emedicine.com/pmr/topic112.htm

and a good PDF article attached above .

Of course , you are OT knows that we are just searching for knowledge basing the search on the reilable diagnosis of the MD .I will try to read as possible from the links above then give my view .I think if the case is Myositis ossificans it is better to let that resolve by itself , i saw before around 3 patients with Myositis ossificans just anterior to the elbow aspect ,with rehabilitaion the extension gained very well , the flexion was blocked by the Myositis ossificans ,i refused to apply any aggressive procedures at that time ,i saw one child from them after 6 months .The bony ossification resolved alone .and the flexion ROM was fully function .

Hope my views are not causing problem for you ,just collect knowledge then decide !!

Cheers
Emad

[rafeekmk]

thank you for the great link.... PDf attachment

[PhysioP]

Hay, sorry to hear about your husband. Thought I would just put in my 2 cents...

HO can turn into a very chronic and life dibilitating condition if not properly treated. Bone scans are essential in assessing the maturity of the HO, and invasive treatments should only be under taken once it is sure to have reached this stage.

HO can also be provoked further by local irritation and inflammation. I once had a client with HO who's condition became severely life affecting due to constant irritation (man refused to stop certain ADL's). This is sometimes what makes HO such a large problem in people with TBI's. Therefore, it is probably a good idea to talk to your therapist about exercises / stretches which cause the least irritation to the bony mass.

In your situation, I would double check with your MD to ensure that it is the appropriate time to undertake surgery. If the HO has not reached maturity, continue with the therapy until it has and then assess the ROM / functional limitations and decide on further treatment from that point.

Far from everything is known about HO, and this information is just off the back of my skull, so please, as allways, consult your doctor before acting on any information provided Thanks!

[mark456]

I think the patient needs just time of simple ,well-designed manual therapy to avoid aggrvating pain and very important recieving well education regarding what to do and what not to do , time of activity ......just not stressing long times .
i saw before around 3 patients with Myositis ossificans just anterior to the elbow aspect ,with rehabilitaion the extension gained very well , the flexion was blocked by the Myositis ossificans ,i refused to apply any aggressive procedures at that time ,i saw one child from them after 6 months .The bony ossification resolved alone .and the flexion ROM was fully function .

mark456

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