Prise en charge des paraostéoarthropathies neurogènes (POAN) chez le traumatisé crânio-encéphalique : étude de la littérature
- 作者：Pé ; lissier ; J. ; Petiot ; S. ; Bé ; naï ; m ; C. ; Asencio ; G.
- 关键词：paraosté ; oarthropathie ; traumatisme crâ ; nien ; neurogenic heterotopic ossifications ; brain injury
- 刊名：Annales de Readaptation et de Medecine Physique
- 出版年：2002
- 期刊代码：13_01686054
- 类别：med
- 出版时间：May, 2002
- 卷：45
- 期：5
- 页码：188-197
- 文件大小：94.0 K
摘要
This article is a review of the literature about treatment of neurogenic heterotopic ossifications (NHO) in brain injured patients, from analysis of the main data bases (Medline, Embase, Reedoc). In spite of the hope they arouse in the seventies, biphosphonates, including etidronate, have not demonstrated their efficiency to inhibit NHO in clinical practice. In fact a very early diagnosis, with the scintigraphic overactivity of the joint area and the increase of serum alkalin phosphatases, must lead to begin passive motion and postures, and may contribute to save functional range of motion. Yet, when joint stiffness or even ankylosis have led to severe functional disorders, surgery with NHO resection is the only way; it looks more reliable to manage it when NHO is mature, after a delay of more than 12 months after the first signs, but earlier operations have been reported without an enhanced risk of recurrence; this surgery must be associated with continous passive motion for several weeks; radiation therapy and/or non-steroid anti-inflammatory drugs have been proposed in the immediate after-surgery period, but their role is still discussed.