Prosthetic replacement of elbow in postburn bony ankylosis: long-term results

Baksi, DP; Pal, Arijit; Chatterjee, Nandini

doi:10.1007/s00264-008-0595-y

Cited by 8 publications

(17 citation statements)

References 14 publications

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“…14, Thirty-four studies documented the outcomes of a total of 286 surgical interventions for postburn HO/BA (Table 3). 64 In total, there were 21 cases (7.34%) of postoperative HO/BA recurrence. 14,22-71 Ninety-seven percent of these studies used bony block excision as the operative technique and the remaining operative techniques included excisional arthroplasty, total arthroplasty, and Baksi sloppy hinge prosthetic implantation.…”

Section: Resultsmentioning

confidence: 96%

“…14,22-71 Ninety-one percent of the affected patients had solely extra-articular HO, whereas 9% displayed some degree of intra-articular involvement. 64 Thirty-one percent of the prosthetic implantations were complicated by some degree of infection. 14, The average time from burn until surgical intervention was 18.8 ± 10.9 months.…”

Section: Resultsmentioning

confidence: 99%

“…64 Thirty-one percent of the prosthetic implantations were complicated by some degree of infection. 57,64 The most common initial clinical symptoms are a decreased ROM of the affected joint, joint pain, and ulnar nerve dysfunction. 14, discussion Lloyd-Williams 72 was the first to describe postburn HO involving a segment of bone extruding through a 30-year-old burn wound; however, Johnson 22 was the first to describe HO in the English literature in 1957.…”

Section: Resultsmentioning

confidence: 99%

“…14,46 The initial management of postburn HO and BA includes both surgical and nonsurgical therapy. 41 Baksi et al 64 reported good results with the use of the Baksi sloppy hinge total prosthesis, with an average gain in arc of motion of 90.9° in postburn BA patients. 42,75,76 Once HO has been diagnosed, most authorities recommend immediate discontinuation of passive ROM therapy and the initiation of active ROM therapy within the pain-free range.…”

Section: Resultsmentioning

confidence: 99%

“…59 A review of the existing literature has identified only 21 documented cases of HO recurrence after surgery, 29% of which were associated with preoperative complete ankylosis. 64 Prosthetic interventions carry an increased risk of postoperative infection which is not insignificant. Less common complications include operative site wound dehiscence, hematoma formation, infection, delayed wound healing, and elbow capsule contracture.…”

Section: Resultsmentioning

confidence: 99%

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Corrective and Reconstructive Surgery in Patients With Postburn Heterotopic Ossification and Bony Ankylosis

Pontell

Sparber

Chamberlain

2015

Journal of Burn Care & Research

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Articular heterotopic ossification (HO) and subsequent bony ankylosis (BA) are infrequent yet devastating complications of severe burn injuries. These conditions are diagnosed clinically and confirmed by imaging. Patients then begin active physical therapy until cleared for surgery, which remains the standard of care. This study critically reviews the existing literature on the diagnosis, treatment, and surgical outcomes of HO/BA in severely burned patients and provides an evidence-based treatment algorithm. A comprehensive search for all the studies addressing HO and BA after burn injury was conducted using PubMed and Google Scholar from 1957 to 2013. Fifty-one studies on postburn HO/BA have been published, reporting incidences from 0.1 to 35.3%. Most patients suffered from third-degree, thermal burns, with a mean TBSA of 49 ± 14%. The mean time from burn until diagnosis was 7 ± 11 months. Seventy-nine percent of the affected joints were elbows and 84% had adjacent and/or overlying burns. Ninety-one percent of joints had solely extra-articular HO. Ninety percent of HO/BA cases were treated with anatomic excision, and all achieved appreciable increases in range of motion with infrequent recurrence. Perioperative radiotherapy was used infrequently. Surgical articular reconstruction is the standard of care for postburn HO/BA severe enough to limit joint movement and/or function. Early detection and initiation of physical therapy are paramount in preventing progression to complete BA. Increased awareness and more rapid means of detecting postburn articular changes may permit earlier discontinuation of passive range of motion exercises, thereby halting the initiation and progression of HO.

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Section: Resultsmentioning

confidence: 96%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Corrective and Reconstructive Surgery in Patients With Postburn Heterotopic Ossification and Bony Ankylosis

Pontell

Sparber

Chamberlain

2015

Journal of Burn Care & Research

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Total Elbow Arthroplasty from Indian Perspective: A Systematic Review

Tiwari

Dwidmuthe

2022

JOIO

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Inverted 'V' osteotomy excision arthroplasty for bony ankylosed elbows

Rex

Periyasamy

Balaji

et al. 2011

Journal of Orthopaedic Surgery and Research

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BackgroundBony ankylosis of elbow is challenging and difficult problem to treat. The options are excision arthroplasty and total elbow replacement. We report our midterm results on nine patients, who underwent inverted 'V' osteotomy excision arthroplasty in our hospital with good functional results.MaterialsOur case series includes 9 patients (seven males and two females) with the mean age of 34 years (13-56 years). Five patients had trauma, two had pyogenic arthritis, one had tuberculous arthritis, and one had pyogenic arthritis following surgical fixation.ResultsThe average duration of follow up is 65 months (45 months-80 months). The mean Mayo's elbow performance score (MEPS) preoperatively was 48 (35-70). The MEPS at final follow up was 80 (60-95). With no movement at elbow and fixed in various degrees of either flexion or extension preoperatively, the mean preoperative position of elbow was 64°(30°to 100°). The mean post operative range of motion at final follow up was 27°of extension (20-500), 116°of flexion (1100-1300), and the arc of motion was 88°(800-1000). One patient had ulnar nerve neuropraxia and another patient developed median nerve neuropraxia, and both recovered completely in six weeks. No patient had symptomatic instability of the elbow. All patients were asymptomatic except one patient, who had pain mainly on heavy activities.ConclusionWe conclude that inverted 'V' osteotomy excision arthroplasty is a viable option in the treatment of bony ankylosis of the elbow in young patients.

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Prosthetic replacement of elbow in postburn bony ankylosis: long-term results

Abstract: Fifteen

Cited by 8 publications

References 14 publications

Corrective and Reconstructive Surgery in Patients With Postburn Heterotopic Ossification and Bony Ankylosis

Corrective and Reconstructive Surgery in Patients With Postburn Heterotopic Ossification and Bony Ankylosis

Total Elbow Arthroplasty from Indian Perspective: A Systematic Review

Inverted 'V' osteotomy excision arthroplasty for bony ankylosed elbows

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