Bone and Joint Changes Following Burns

Evans, E. Burke; Smith, James R.

doi:10.2106/00004623-195941050-00001

Cited by 66 publications

(12 citation statements)

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“…The disturbance of distal tibial growth, secondary to extravasational injury, was ascribed to occlusion of perichondrial vessels. A similar mechanism may account for the skeletal changes after burns, 19 although tethering by a scar may be more important than ischaemia of the growth plate.…”

Section: Discussionmentioning

confidence: 99%

Arrest of the growth plate after arterial cannulation in infancy

Macnicol

Anagnostopoulos

2000

The Journal of Bone and Joint Surgery. British volume

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Seven children who had partial arrest of the growth plate after neonatal arterial cannulation, developed obvious skeletal changes in adolescence. Cannulation of the femoral artery produced ischaemia which led to four cases of ipsilateral shortening of the lower limb and one of partial arrest of the proximal femoral physis with subsequent coxa valga. The two arrests in the upper limb affected the humerus, ulna and radius, and the radius alone, after cannulation of the brachial and radial arteries, respectively. These late effects of cannulation are not widely appreciated, and may occur as a result of thrombosis rather than extravasation. Arrest of the growth plate (physis) may complicate arterial cannulation during infancy and childhood. The resultant discrepancy or deformity of the limb is not always recognised before skeletal maturity, by which time a relatively simple correction by epiphysiodesis is impossible. We describe seven cases of physeal injury after arterial cannulation in which complications such as perforation of the vessel wall, aneurysm or extravasation were not sustained. Two cases involved the upper limb, producing shortening of the radius principally, but also of the ulna and the humerus. Four cases of femoral and tibial shortening occurred as a result of femoral cannulation. Although there has been debate in the literature about the cause of the resultant leg-length disparity, since an intrinsic mild discrepancy cannot always be ruled out in each of our patients, the ipsilateral leg had developed mild circulatory impairment after the cannulation. The last case involved the lateral portion of the proximal femoral growth plate.

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Section: Discussionmentioning

confidence: 99%

Arrest of the growth plate after arterial cannulation in infancy

Macnicol

Anagnostopoulos

2000

The Journal of Bone and Joint Surgery. British volume

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“…However, HO only rarely occurs following burns. 6,17 In a study of 950 patients with burns, Evans and Smith 6 found only four patients who had peri-articular ossification, none of them involved the knee. Involvement of the knee is uncommon even in patients with HO following traumatic brain injury in whom a high incidence of HO has been reported varying from 11-76% 23 and it rarely requires excision.…”

Section: Discussionmentioning

confidence: 99%

“…Exact pathogenesis of HO following burns is not well understood but circulatory stasis, tissue hypoxaemia and immobility have been hypothesised to play a role. 6,17 The proximity of the involved joint to the area of the burn is not a pre-requisite and the HO may develop around a joint far from the site of the burn. 6,17 In the present case, the patient developed HO on the right side although the burnt area was larger on the left side (Fig.…”

Section: Discussionmentioning

confidence: 99%

“…4,14 HO formation following burns is rare, with very few cases reported. 6,17 Periarticular HO affects the knee less often than the shoulder, elbow and hip joints, even in patients with traumatic brain injury where the incidence of heterotopic ossification varies from 11-76%. 9, 16 HO of the posterior knee is rare 1,3,16 and for this to require surgical excision is exceptional.…”

Section: Introductionmentioning

confidence: 99%

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Surgical excision of post-burn heterotopic ossification of the popliteal space

2005

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“…Loss of movement at the elbow after trauma, burns or coma may cause severe impairment of function [1][2][3][4] which is difficult to avoid and to treat. Several differing surgical procedures have been used.…”

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confidence: 99%

The medial approach for operative release of post-traumatic contracture of the elbow

Wada

Ishii

Usui

et al. 2000

The Journal of Bone and Joint Surgery. British volume

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We treated post-traumatic contracture of the elbow in 13 consecutive patients (14 elbows) by operative release. Through a single medial approach, the posterior oblique bundle of the medial collateral ligament was resected, followed by posterior and anterior capsulectomies. An additional lateral release through a separate incision was required in only four elbows. The results were assessed at a mean interval of 57 months after operation.Before surgery active extension lacked 43° which improved to 17° after operation. Active flexion before operation was 89°, which improved to 127°. The mean arc of movement increased from 46° to 110°. All 14 elbows showed scarring of the posterior oblique bundle of the medial collateral ligament.Neither the interval from injury to operative release nor the age of the patient affected the results. A medial approach is useful to reveal and excise the pathological changes in the medial collateral ligament. It is a safe and effective route through which to correct post-traumatic contracture of the elbow.

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Bone and Joint Changes Following Burns

Cited by 66 publications

References 0 publications

Arrest of the growth plate after arterial cannulation in infancy

Arrest of the growth plate after arterial cannulation in infancy

Surgical excision of post-burn heterotopic ossification of the popliteal space

The medial approach for operative release of post-traumatic contracture of the elbow

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