Extracorporeal Shockwave Therapy for Painful Chronic Traumatic Heterotopic Ossification after Right Acetabulum Fracture Fixation: A Case Report and Literature Review
DOI:
https://doi.org/10.3889/oamjms.2020.4726Keywords:
Extracorporeal shockwave therapy, Heterotopic ossification, case reportAbstract
BACKGROUND: Heterotopic ossification (HO) usually occurs in trauma, such as fractures. To the best of our knowledge, there is a lack of studies about the effects of shockwave on the size of HO in the literature.
AIM: The aim of this study was to describe the effects of extracorporeal shockwave therapy (ESWT) on the size of HO as well as the lower extremity functions in patients with fracture right acetabulum.
CASE REPORT: A 36-year-old gentleman had a traffic accident on August 30, 2015, resulted in a fracture of the right acetabulum treated by open reduction and internal fixation on September 2, 2015. The patient has complained of severe right hip pain with limitation of daily activities, especially walking, standing, and sitting, visual analog scale about 7-8/10 with painful and restricted ROM of the right hip. Plain X-ray of the right hip revealed HO at greater trochanter with a long axis length 37.3 mm. ESWT was applied for HO. ESWT was administered 6 times each weekly for 6 weeks. At 6-month follow-up, the size of HO had become slightly smaller with the improvement of pain, and lower extremities functions.
DISCUSSION: Soft tissues around HO have been regenerated from ischemia for several reasons such as ESWT stimulating angiogenesis and neurogenesis and the size of HO had become slightly smaller by radial shockwave therapy.
CONCLUSION: ESWT is a novel non-invasive and safe treatment for HO. The effects of ESWT on the size of HO had become slightly smaller with the improvement of lower extremities functions.
Downloads
Metrics
Plum Analytics Artifact Widget Block
References
Pacos EE, Stafilas KS, Tsekeris PG, Politic AN, Mitsionis G, Xenakis TA. Combined radiotherapy and indomethacin for the prevention of heterotopic ossification after total hip arthroplasty. Strahlenther Onkol. 2009;185(8):500-5. https://doi.org/10.1007/s00066-009-1954-3 PMid:19652932 DOI: https://doi.org/10.1007/s00066-009-1954-3
Gleitz M. Myofascial Syndromes and Trigger Points-shock Wave Therapy in Practice. 1st ed. Heilbronn: Publishig House; 2011. p. 208.
Moon SH, Lee S, Kim KH. Ultrasound-guided exact focusing of extracorporeal shock wave therapy for the calcific tendinitis of gluteus medius-a case report. J Korean Orthop US Soc. 2012;5:94-8.
Cho YS, Park SJ, Jand SH. Effects of the combined treatment of extracorporeal shock wave therapy (ESWT) and stabilization exercises on pain and functions of patients with myofascial pain syndrome. J Phys Ther Sci. 2012;24:1319-23. https://doi.org/10.1589/jpts.24.1319 DOI: https://doi.org/10.1589/jpts.24.1319
Brissot R, Lassalle A, Vincendeau S, Polard JL, Fouche M, Ninubona D, et al. Treatment of heterotopic ossification by extracorporeal shock wave: 26 patients. Ann Readapt Med Phys. 2005;48(8):581-9. https://doi.org/10.1016/j.annrmp.2005.04.014 PMid:15993976 DOI: https://doi.org/10.1016/j.annrmp.2005.04.014
Reznik JE, Milanese S, Golledge J, Biros E, Gordon S, Galea MP. Extracorporeal shock wave therapy as a treatment for heterotopic ossification. Phys Ther Rev. 2013;18:300-7. https://doi.org/10.1179/1743288x13y.0000000084 DOI: https://doi.org/10.1179/1743288X13Y.0000000084
Rothwell AG. Quadriceps hematoma: A prospective clinical study. Clin Orthop Relat Res. 1982;171:97-103. PMid:6814806 DOI: https://doi.org/10.1097/00003086-198211000-00017
Kim H, Cheon JH, Lee DY, Cheon JH, Cho YK, Lee SH, et al. Intramuscular hematoma following radial extracorporeal shockwave therapy for chronicneurogenic heterotopic ossification: A case report. Ann Rehabil Med. 2017;41(3):498- 504. https://doi.org/10.5535/arm.2017.41.3.498 PMid:28758090 DOI: https://doi.org/10.5535/arm.2017.41.3.498
Mc Carthy E. Heterotopic ossification: A review. Skeletal Radial. 2005;34(10):609-919. PMid:16132978 DOI: https://doi.org/10.1007/s00256-005-0958-z
Choi YM, Hong SH, Lee CH, Kang JH, Oh JS. Extracorporeal shock wave therapy for painful chronic neurogenic heterotopic ossification after traumatic brain injury: A case report. Ann Rehabil Med. 2015;39:318-22. https://doi.org/10.5535/arm.2015.39.2.318 PMid:25932431 DOI: https://doi.org/10.5535/arm.2015.39.2.318
Downloads
Published
How to Cite
Issue
Section
Categories
License
Copyright (c) 2020 Mohieldin M. Ahmed, Shothour M. Alghunaim, Douaa M. Mosalem, Sherif M. Khairat, Farah Abdel Hameed (Author)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
http://creativecommons.org/licenses/by-nc/4.0