East and Central African Journal of Surgery Association of Surgeons of East Africa and College of Surgeons of East Central and Southern Africa ISSN: 1024-297X EISSN: 2073-9990 Vol. 11, Num. 2, 2006, pp. 113-113

East and Central African Journal of Surgery, Vol. 11, No. 2, December, 2006, pp. 113

Myositis Ossificans: A Case Report.

Asfaw Ayele, Orthopaedic Surgeon, Menilic Hospital, Addis Ababa Pobox 25165 code 1000 Ethiopia

Code Number: js06042

Introduction

Among the various joints of our musculoskeletal system, the elbow joint is one of the most highly sensitive joints to passive stretching exercise especially if it immobilized for longer than three weeks. In our society the majority of the peoples are strongly bound to the traditional bone setters that deal with tight bamboo splinting, forceful reduction, massage and over enthusiastic passive movement which can precipitate myositis ossificans. Such a case is presented.

Case Report

The patient was a 25 years old male patient from Addis Ababa who reported to have been in good health until six weeks prior to admission when he had a fell from a stair and injured his left elbow. He went to the near by traditional bone setter where forceful reduction of dislocation of the left elbow was done fallowed by massage and passive stretching exercise. Finally he started to experience limitation flexion-extension of the elbow for which presented to our referral clinic where he was investigated and found to have heterotopic ossification on the anterior aspect of the elbow Arrow Figure 1).

Discussion

Dislocation of elbow joint should be reduced with a simple and gentle maneuver. Any Forceful attempt to reduce the fracture or dislocation should be avoided. After a gentle reduction the joint should be immobilized with a posterior slab for a maximum of three weeks. By the end of three weeks the elbow should be free. It is not uncommon to see stiff elbow after immobilization. The worst treatment is to attack an injured and stiff elbow with vigorous muscle stretching exercise. This procedure precipitates the condition. Thus enthusiastic passive stretching exercise There is a need to educate to the traditional bone setters and physiotherapist about this danger so that they to avoid over enthusiastic passive stretching exercises.

© 2006 East and Central African Journal of Surgery

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