Heterotopic Ossification - Shoulder

kachingchingpow · 05-17-2009, 19:41

In January, my son and I were in a very bad motorcycle accident. We were t-boned by a young girl in a Volkswagon.

The impact occurred on the right side, and of course I went sailing about 50 feet to the left. Evidently when I came down, I must have not performed a proper PLF and landed such that I ripped my left shoulder to shreds. The EMT's put it back into place at the scene, but it came back out when I rolled onto it in the ICU. A day or so later they scoped it and then performed an open "massive" rotator cuff repair.

I don't have all the particulars in front of me regarding exactly what was done, other than I know that I now have 4 screws and a bunch of nylon line holding everything back in place. The Dr. had me in a sling for 3 months. I started passive PT at 2 months, and full ROM PT at 3. His remarks were that the shoulder basically looked like a bomb went off inside, and that he rarely see's them this bad. Certainly only in high impact trauma.

It's been about a month now since I started heavy PT, and haven't seen a ton of improvement in my external rotation, abduction, or elevation. At my last visit, my Dr. explained that "heterotopic ossification" is visible, and that I'm going to have some stiffness to deal with. Of course at this point, he became a little more conservative in terms of making a prognosis, and I really didn't know what questions to ask either.

Just curious if anyone here know's how well this condition will respond to ongoing PT, and at what point do I begin inquiring about more surgery. If surgery is an option, can someone explain what's involved with it, and what can generally be expected afterwards? Is it an open procedure, or scope? What questions should I be asking my osteo?

Thanks for your time and assistance.

C

Red Flag 1 · 05-18-2009, 05:48

if it worth saying, it will be quoted.

Boomer-61 · 05-27-2009, 12:21

C,
I see H.O. mostly in trauma but at times it accumulates after routine hip surgery. (A type of controlled trauma) It is calcification within the muscle tissue itself. Some times when present the patient is asymptomatic, the patient doesn't even know it's there. Some times it can be very debilitating and limit motion. At this point in your recovery I would continue with your rehab and just see how things turn out. If your injury is as bad as you indicate I would expect you to improve for 6-9 months. If at the end of that period you are limited in a way that is unacceptable consider why. Is it because of the H.O. or is it just because you had a really bad injury and this is as good as it will get. If however there is a large amount of H.O. in and around your shoulder and your surgeon is certain it is your limiting factor consider your options. Will excision of the mass make you better? Will excision of the mass do more damage? If the mass is removed, will it reaccumulate? We have done a few H.O. removals with good results but we did one or two concurrent therapies, low dose radiation (current preference) and or indomethacin. How is your son?
Good luck to you both,
Boomer

Blitzzz (RIP) · 05-27-2009, 15:40

In Physical therapy we had some sucess with ascedic acid in IONTOphoresis. Check with your Physical therapist.

The vinegar is run through the muscle fiber electricaly and desolves the calcified material.

If you want to see what vinegar does to calcium just put some in a class jar with a chicken leg bone and give it a few days. You will have what looks like a bone but can be tied in knots. Blitzzz

kachingchingpow · 05-29-2009, 11:17

Hey Blitzz, I just got out of therapy and one of the PT's was mentioning that, as well as Dextramethadone (I believe that's what they said it was). Interesting stuff.

Blitzzz (RIP) · 05-29-2009, 12:08

The Dex is a steriod and is good for inflammation in the tendon and ligiments as well as muscle. The Acidic Acid (medical grade Vinegar) will desolve the assess calcium. Note that it needs be controlled as it also takes some of the normal bone with will grow back while the ossification generally does not. Go for it. Blitzzz

kachingchingpow · 05-30-2009, 22:47

Thanks for the continued updates fellas. I'll do whatever it takes to get to the point where I can at least put on a glove an play catch with my daughter.

Boomer, my son is doing well all things considered. It looks like he won't have any long term issues such as mine. His injuries included a broken femur neck, broken tib & fib, broken ankle, and a broken radius. Until Thursday, he had an internal fixator on the hip, external fixator w/ pins on the tib/fib and a screw in the ankle. His radius had a cast for several weeks, but has been off for some time now. Scottish Rite here in Atlanta pulled all of it out, and they expect a full recovery. I'll be honest, it was a very emotional day at the hospital the other day. I was in a coma for 4 days while he was going through all of this after the accident, and I didn't see him for a month while we were both in separate hospitals. Seeing him go through this in person was tough.