A sternocleidomastoid incision was performed and carried down through the platysma muscle. He was sent to the operating room for neck exploration to rule out vascular injury and injury to the aerodigestive tract (respiratory and digestive tracts). CT scan revealed no hard evidence of arterial injury but a bullet was directly in line with the internal jugular vein. Resection can generally be performed after 6 to 9 months and usually after bone matures.Д®arlier resection with secondary prophylaxis with single-dose radiation or nonsteroidal antiinflammatory medications may be safe.Д®arly surgical intervention may provide more effective rehabilitation and dramatic improvements in patient function.A 63 year-old man sustained a gunshot wound through the right maxillary sinus penetrating into the right neck. Need to combine with nonsteroidal antiinflammatory drugs and/or radiation Impaired range of motion not amenable to conservative measures Peripheral nerve compromise due to compression Radiation has been used in heterotopic ossification related to spinal cord injury and in conjunction with removal of heterotopic ossificationД®xtracorporeal shock wave therapy has been used successfully May need long-term treatment (at least 6 months) May develop rebound and bone growth after discontinuation due to resumption of osteoid mineralization while osteoclast function remains suppressed Inhibition of precipitation of calcium phosphateДelaying aggregation of hydroxyapatite crystalsД«locking conversion of calcium phosphate into hydroxyapatite May be effective in other forms of heterotopic ossification including burns and spinal cord injury Have been effective in neurogenic heterotopic ossification

Later (If Heterotopic Ossification Develops) May inhibit the differentiation of pluripotent mesenchymal cells into osteoblastsД¬omplications include soft tissue contracture, delayed wound healing, and theoretically malignancyД®qually effective as nonsteroidal antiinflammatory drugs Has been effective prophylactically for perioperative care of total hip arthroplasty Selective cyclooxygenase (COX)-2 inhibitors may be equally effective The mechanism of action includes inhibition of differentiation of mesenchymal cells into osteogenic cells and suppression of the prostaglandin-mediated inflammatory response. Nonsteroidal antiinflammatory drugs have been effective after total hip arthroplasty. Gentle range of motion within a pain-free zone Magnetic resonance imaging may be useful in the preoperative setting to help describe relationships to other structures.Д¬omputed tomography can delineate zonal pattern of calcification and can be diagnostic before radiographs.Д¬omputed tomography with three-dimensional reconstruction may be used for preoperative planning.

Magnetic resonance imaging is not typically used but can identify a nonspecific soft-tissue mass within the first few weeks. Ultrasound can detect heterotopic ossification sooner than radiographs, computed tomography, or magnetic resonance imaging, and enables early identification and treatment. It is usually positive by 2 to 4 weeks and can be used to predict the optimal timing for surgical resection. Nuclear medicine bone scan is the most sensitive imaging modality for early heterotopic ossification and can be used to indicate whether the lesion is active or has matured. Radiographic abnormalities can be seen within 18 to 21 days but may take 4 to 5 weeks to develop and should be present by 8 weeks.

Icd 10 code soft tissuemass of elbow