JBJS | Article

The Journal of Bone & Joint Surgery, Volume 90, Issue 5

Case Reports | May 01, 2008

Successful Elbow Contracture Release Secondary to Melorheostosis: A Case Report

Hyun Sik Gong, MD, PhD¹; Kyung Hak Lee, MD¹; Joo Han Oh, MD, PhD¹; Jin-Haeng Chung, MD, PhD¹; Goo Hyun Baek, MD, PhD¹; Moon Sang Chung, MD, PhD¹

¹ Departments of Orthopedic Surgery (H.S.G., K.H.L., J.H.O., G.H.B., M.S.C.) and Pathology (J.-H.C.), Seoul National University Bundang Hospital, Seoul National University College of Medicine, 300 Gumi-dong, Bundang-gu, Seongnam-si, Gyeonggi-do, 463-707, South Korea. E-mail address for H.S. Gong: hsgong@snu.ac.kr

The Journal of Bone & Joint Surgery. 2008; 90:1106-1111 doi:10.2106/JBJS.G.00961

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Extract

Melorheostosis is a rare, noninheritable developmental dysplasia of cortical bone that is often characterized by a classic radiographic pattern of flowing hyperostosis along the cortex of long bones¹. Patients with this condition may have joint pain, stiffness, deformity, and restricted range of motion due to soft-tissue contracture². Involvement usually follows a sclerotomal distribution³ and usually affects only one extremity^4,5. Joint contracture occurs when the abnormal ossification in the cortex of the long bone involves the soft tissues and extends into the joint, resulting in soft-tissue fibrosis and contracture^2,5,6. There is no specific treatment for this condition; options range from nonsurgical management (e.g., splinting and early training in making optimal use of the unaffected extremity) to various types of surgical management (e.g., tendon lengthening, sympathectomy, implant arthroplasty, or even amputation². The literature indicates that surgical release of a joint contracture may be difficult and that recurrence of the deformity is frequent^2,4-6.

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Topics

melorheostosis ; elbow contracture

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These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.

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