Elbow joint ossifying myositis

　　After an elbow joint injury, local hematoma formation occurs. Since the hematoma is not absorbed and becomes fibrous and cartilaginous tissue, it is one of the key factors in the formation of elbow joint ossifying myositis. Elbow joint injuries include muscle injury, periosteal rupture or avulsion, hemorrhage of the periosteum and surrounding soft tissue. The hematoma causes an aseptic inflammatory reaction, and newly formed capillaries, phagocytes, and osteoblasts in the deep layer of the periosteum are active in the short term after the injury,侵入附近的肌肉内发生骨化.

　　Factors related to the formation of ossifying myositis

　　(1) Traumatic ossifying myositis can not only occur after a single major injury but also after chronic, cumulative sprains and strains. Some patients with trauma have original injuries that are not severe, but due to unnecessary local massage or inappropriate lifting of heavy objects, etc., repeated injuries occur.

　　(2) Striving for early and accurate reduction and effective fixation can prevent the formation of hematoma and is conducive to the repair of injured tissues. Generally, the ossification activity is most active within 2 weeks after a fracture or dislocation injury, and repeated manual reduction during this period can promote the formation of heterotopic ossification.

　　(3) The incidence of ossifying myositis in children is significantly higher than that in young and middle-aged adults. This is because the periosteum of children is thicker, and it grows faster after injury. Ossification occurs in the elbow joint after fractures, dislocations, or injuries where the periosteum is stripped, and local hematoma formation; or after passive traction, part of the hematoma gradually absorbs, while part of it produces ossification under the periosteum.

　　Osteoarthritic tenosynovitis of the elbow joint has few complications, but due to the characteristics of the elbow joint itself, serious complications can also occur. Since the elbow joint is the most sensitive to massage and passive movement, due to iatrogenic reasons such as rough massage, repeated strong passive stretching of the joint, and other reasons, repeated injury to the elbow joint can cause repeated bleeding, and repeatedly formed adhesions and ossification can cause the elbow joint to become completely rigid, which is also the most common and serious complication of the disease.

　　Patients with osteoarthritic tenosynovitis of the elbow joint can feel a relatively hard soft tissue mass in the elbow, which gradually increases in size, accompanied by pain. After about 8 weeks, the growth stops, the pain subsides, but the range of motion of the elbow joint is limited. The mass ossifies several weeks to several months after the injury.

　　1. There is a clear history of trauma.

　　2. Repeated passive flexion and extension of the joint after injury.

　　3. The joint swelling, pain persists without subsiding, accompanied by local temperature rise.

　　4. The range of joint movement gradually decreases.

　　5. There are no special findings on X-ray in the early stage, and cloud-like ossification masses are found around the joint after 3 to 4 weeks. In the late stage, the range of ossification decreases, the density increases, and the boundaries become clear. Generally, there is an increasing trend within 3 to 6 weeks after the injury, and it tends to stabilize after 6 to 8 weeks.

　　To prevent the occurrence of osteoarthritic tenosynovitis of the elbow joint, attention should be paid to the following aspects:

　　1. If the elbow joint is accidentally injured, it should be treated immediately at a hospital. Proper treatment can reduce elbow bleeding and prevent the formation of an elbow hematoma as much as possible.

　　2. Fractures and dislocations of the elbow joint may lead to functional limitation due to long-term immobilization. At this time, the patient should not be anxious and should gradually perform active functional exercises as tolerated, while also配合中药熏洗肘关节. After a period of treatment, the function can be completely restored.

　　3. It is imperative not to be impatient and to perform strong passive stretching of the elbow joint, as this is very likely to trigger osteoarthritic tenosynovitis of the elbow joint.

　　If osteoarthritic tenosynovitis of the elbow joint has formed, early patients should not over-exercise if there are symptoms such as swelling, tenderness, and fever locally. At this time, it is advisable to actively practice joint movement when the symptoms are not obvious and the pain is bearable. If the ossification tissue has matured in the later stage, and X-ray films show that the range of ossification tissue has decreased and is localized in a certain area, at this time, the patient should choose surgical treatment to remove the ossification tissue to improve the function of the elbow joint. Radiotherapy is also needed after surgery to prevent recurrence.

　　Patients with osteoarthritic tenosynovitis of the elbow joint show no special symptoms other than the primary injury in the early stage. After 3 to 4 weeks, cloud-like ossification masses can be found around the elbow joint. After the fourth week, X-ray films show ossification at the tendinous attachment site or fracture site, which usually lasts for 6 to 8 weeks. In the late stage, the range of ossification decreases, the density increases, and the boundaries become clear. X-ray films show the formation of ossification masses, which are ossification masses or osteophytes with regular edges and uniform density, such as the olecranon osteophyte. In addition, traumatic hematoma appears in the swollen muscle area, which can show feather-like calcification. The hematoma distributes along the interlayer of the muscle bundle, and irregular calcification shadows appear on the cyst wall.

　　The main examination methods for this disease are X-ray examination, and different types have different manifestations:

　　1. Early stage

　　X-ray examination shows that there is no typical ossification in the early stage, but irregular cotton wool-like shadows can be displayed in the soft tissue.

　　2. Maturity

　　After the formation of ossification or the early ossification has hardened after the injury of the elbow joint, the X-ray can show a smooth edge of the bone density-like shadow, and the range of the shadow is smaller and concentrated than before.

　　Patients with ossifying myositis of the elbow joint should have a light diet, pay attention to dietary balance. Eat more vegetables and fruits, such as bananas, strawberries, apples, etc. Because they are rich in nutrients, eat more immune-boosting foods such as propolis to enhance personal disease resistance. In daily life, it is also necessary to rationally match the diet and pay attention to adequate nutrition. Avoid spicy and刺激性 food. Avoid greasy, smoking, and drinking. Avoid eating cold food to prevent recurrence of the disease.

　　Ossifying myositis of the elbow joint is generally caused by repeated traction after trauma, and is caused by prolonged hematoma stimulation. The treatment methods include the following:

　　1. General Treatment

　　After the diagnosis of ossifying myositis is established, the elbow joint should be properly protected, and whether to perform active joint exercise should be determined according to the situation. If there is swelling, tenderness, and increased temperature locally, and the pain worsens during movement, excessive activity should not be performed. If the above symptoms are not obvious, exercise should be performed under tolerable pain to retain a certain degree of joint movement and function.

　　2. Radiotherapy

　　Some people believe that radiotherapy can affect the inflammatory reaction process and prevent the occurrence of ossifying myositis. Twice a week, a course of 4 weeks, each time 200R.

　　3. Surgical Treatment

　　Only when the ossifying myositis is stationary, that is, the dense ossification is clear, can surgery be considered for resection. The purpose of resection is not to leave any muscle or bone tissue related to the ossification mass, in order to prevent recurrence. It is advisable to resect the ossification mass along with a thin layer of normal muscle and stop bleeding completely. The cast is fixed for 1 to 3 weeks after surgery.