Clinics in Orthopedic Surgery  2016;8(3):339-344

doi:10.4055/cios.2016.8.3.339

Bilateral Scapulohumeral Ankylosis after Prolonged Mechanical Ventilation.

Manon L VAN LOTTEN 1 ; J Rieneke SCHREINEMAKERS ; Arthur VAN NOORT ; Maarten V RADEMAKERS

Affiliations

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Keywords

Heterotopic ossification; Ankylosis; Shoulder joint; Artificial respiration

Country

Republic of Korea

Language

English

Abstract

This case demonstrates a rarely reported bilateral scapulohumeral bony ankylosis. A young woman developed extensive heterotopic ossifications (HOs) in both shoulder joints after being mechanically ventilated for several months at the intensive care unit in a comatose status. She presented with a severe movement restriction of both shoulder joints. Surgical resection of the bony bridges was performed in 2 separate sessions with a significant improvement of shoulder function afterwards. No postoperative complications, pain, or recurrence of HOs were noted at 1-year follow-up. Mechanical ventilation, immobilization, neuromuscular blockage, and prolonged sedation are known risk factors for the development of HOs in the shoulder joints. Relatively early surgical resection of the HOs can be performed safely in contrary to earlier belief. Afterwards, nonsteroidal anti-inflammatory drugs and/or radiation therapy can be possible treatment modalities to prevent recurrence of HOs.