Elbow myositis ossificans
Introduction
Introduction to elbow joint osteomyelitis Traumatic ossifying myositis is a relatively common secondary injury of elbow joint acute injury, which occurs mostly in elbow joint fracture, dislocation and joint capsule, tendon, ligament and other injuries. The hematoma in the joint area is mechanized and damaged. Man-made strong passive traction, traumatic exudation repeated, resulting in subperiosteal ossification. basic knowledge The proportion of illness: 0.003% Susceptible people: no specific population Mode of infection: non-infectious Complications: ossifying myositis
Cause
Elbow joint osteomyelitis etiology
Cause:
The disease often occurs in elbow fractures, dislocations and other serious injuries, the periosteum is stripped, ruptured, hematoma formation, or partial passive traction, surgical stimulation, formation of hematoma, which can cause hematoma ossification-based ossification process; After the hematoma is absorbed, it gradually develops into the subperiosteal ossification. At present, the mechanism is not very clear. It can be summarized as the periosteal bone theory and the fibrous tissue transformation bone theory.
The occurrence of ossifying myositis is related to the following factors:
1. Repeatedly strong passive activities.
2. Treatment time, early treatment can get a good reduction, reduce hematoma formation, and facilitate soft tissue repair.
3. Age, children have less chance of developing ossifying myositis than young adults.
Prevention
Elbow joint osteomyelitis prevention
Elbow joint ossifying myositis, its exact pathogenesis is still unclear, often associated with elbow trauma, dislocation, fracture, surgery is its main pathogenic factor, therefore, to avoid and reduce hematoma formation after elbow injury, hematoma clearance Early dehydration and swelling, avoiding multiple damage of periosteum, avoiding forced passive activity as an important principle for preventing the occurrence of traumatic elbow ossifying myositis. Early treatment as early as possible, resetting brake, ice application, hemostasis, can reduce the degree of hematoma Early hematoma puncture, correct drainage after fracture is beneficial to clear the hematoma; after injury, raise the affected limb, dehydration medication is beneficial to swelling and subsidence; avoid multiple manipulations, can protect the periosteum of the fracture end, avoid the bone after multiple injury of periosteum The mother cell enters the hematoma, the correct functional exercise and rehabilitation means, combined with Chinese medicine fumigation, physiotherapy is also one of the important ways to avoid traumatic joint ossifying myositis, so the above method can effectively reduce the traumatic ossifying myositis occur.
Complication
Elbow joint osteomyelitis complications Complications ossifying myositis
The disease has fewer complications, but due to the characteristics of the elbow joint itself, it can also form more serious complications. Because the elbow joint is the most sensitive joint for massage and passive activities, due to iatrogenic reasons, such as rough massage. Repeatedly and strongly passively pulling the joints and other reasons can cause repeated injuries to the elbow joint, repeated bleeding, and repeated formation of adhesion ossification, which will cause the elbow joint to be completely stiff, which is the most common and serious complication of this disease.
Symptom
Elbow joint ossifying myositis symptoms Common symptoms Shoulder joint activity restricted joint swelling elbow lateral night pain persistent pain elbow joint pain infectious fever
The diagnosis of this disease includes the following:
1. Have a clear history of trauma;
2, repeated passive flexion and extension joints after injury;
3, joint swelling, pain persists with local temperature rise;
4. The range of joint activities gradually becomes smaller;
5, X-ray early no special, 3 to 4 weeks after the discovery of a cloud-like ossification group around the joint, the scope of late ossification is reduced, the density is increased, the boundary is clear, generally within 3 to 6 weeks after injury, there is an increasing trend, 6 ~ It stabilized after 8 weeks.
Examine
Examination of elbow joint osteomyelitis
The examination methods used for this disease are mainly X-ray examinations, and different types have different performances:
1, the initial type
X-ray examination showed that typical ossification was not formed in the early stage, but irregular shadows of irregular batt in soft tissue were revealed.
2, mature
After the elbow joint injury has formed ossification or initial ossification has been hardened, X-slice can show the edge of the smooth bone density-like shadow, the shadow range is smaller and concentrated than before.
Diagnosis
Diagnosis and differentiation of elbow joint ossifying myositis
The disease is easier to diagnose, so it is often not necessary to distinguish it from other diseases, but it is clinically necessary to identify the different types of the disease, which is related to its treatment:
1, the initial type
After elbow fracture and dislocation treatment, local swelling, fever, severe pain, limited joint activity, mainly manifested as inflammatory changes in the elbow joint and periosteum or joint capsule, and the X-ray does not form typical ossification at the initial stage. It can display irregular shadows of soft cotton in soft tissue. This type appears in 15~40 days.
2, mature
After the elbow joint injury has formed ossification or initial ossification has been hardened, the elbow joint is slightly swollen or muscle stiffness, atrophy, pain gradually relieved or painless, local contact with multiple or single hard mass, joint flexion and displacement activity, X The film shows: the edge of the smooth bone density-like shadow, the shadow range is smaller and concentrated than before, this type occurs more than 40 days later.
