Functional Outcomes of the Surgery and Rehabilitation in a Challenging Case of Heterotopic Ossification after Encephalitis.

Heterotopic ossification is the formation of the lamellar bone where normally osseous tissue does not exist. Since heterotopic ossification can cause severe functional loss, it is a challenging condition for both clinicians and patients. Neurogenic heterotopic ossification is a rare condition after encephalitis. Likewise, in this paper, we have presented a challenging case of heterotopic ossification after viral encephalitis and functional outcomes after the management of heterotopic ossification.

Hypospadias in spinal cord injury: association with indwelling catheter drainage and disturbance of behavior: a report of three cases.

STUDY DESIGN: Case series. OBJECTIVE: To present three cases of paraplegic patients with hypospadias and psychiatric comorbidities. SETTING: Ankara Physical Medicine and Rehabilitation Training and Research Hospital, Ankara, Turkey. CASES: Three spinal cord injured male patients with hypospadias are presented. All three patients had a history of psychiatric disorders that is thought to be a precipitating factor. CONCLUSION: This is the first report in the literature of three cases of hypospadias associated with indwelling catheter drainage and behavioral disturbance.

Wheelchair appropriateness in patients with spinal cord injury: a Turkish experience.

STUDY DESIGN: Descriptive. OBJECTIVE: To determine the wheelchair appropriateness in patients with spinal cord injury (SCI). SETTING: National Rehabilitation Center in Ankara, Turkey. METHODS: Twenty-seven (25 male, 2 female) SCI patients were included. Demographic and clinical characteristics of the patients were noted. All wheelchairs were evaluated considering each part (seat length, seat depth, seat height, back height, armrest, headrest, wheels and seat belt) by a physiatrist who had attended the wheelchair-training course. The wheelchair was declared as inappropriate if at least three parts of wheelchair were not appropriate. RESULTS: The mean age of the patients was 32.9±9.3 years and mean duration of wheelchair use was 19.63±23.02 months. Among the patients, 21 (77.8%) were American Spinal Injury Association Impairment Scale (AIS) A, 4 (3.7%) AIS B, 1 (3.7%) AIS C and 1 (3.7%) AIS D. Five (18.5%) wheelchairs were motorized and 22 (81.5%) were manual. Overall, 15 (55.6%) wheelchairs were inappropriate. Seat height, cushion and back height were the most common inappropriate parts. CONCLUSION: In light of our first and preliminary results, we can argue that 55% of the patients with SCI use inappropriate wheelchairs. In order to achieve better mobility; personally designed wheelchairs should be prescribed by the clinicians.

Postacute predictors of functional and cognitive progress in traumatic brain injury: somatosensory evoked potentials.

OBJECTIVE: To investigate the prognostic value of electrophysiologic studies performed during the postacute phase after traumatic brain injury (TBI). DESIGN: A prospective comparative study in which 26 patients with TBI participated. Patients were grouped according to their admission short-latency somatosensory evoked potential (SEP) results. Nonparametric Kruskal-Wallis and Mann-Whitney U tests were applied to different SEP groups to determine the differences among them in specific functional and cognitive outcome measures. SETTING: An inpatient brain injury rehabilitation unit. PARTICIPANTS: Twenty-six patients with TBI who were admitted to the rehabilitation center at the postacute phase for a late inpatient rehabilitation program and 15 age-matched healthy subjects who served as a control group for the electrophysiologic comparison. MAIN OUTCOME MEASURES: Motricity Index, Barthel Index, Disability Rating Scale, Mini-Mental Status Exam, and Rancho Los Amigos Scale. RESULTS: Disability Rating Scale scores at discharge and rate of change of Barthel Index scores differed between median nerve SEP classification groups (p<.05 for both). Disability Rating Scale scores at admission (p<.05) and at discharge (p<.01), Barthel Index scores at discharge (p<.05), and rate of change of Barthel Index scores (p<.05) differed between tibial nerve SEP classification groups. There was a relation between Motricity Index side scores at discharge and the different body side SEP response groups (p<.0001). Cognitive results showed no relation to the SEP groups. CONCLUSIONS: Postacute SEP scores after a late admission to a rehabilitation center showed a relation to measures of functional and motor progress. Patients with better SEP responses were more likely to experience greater functional and motor improvement. Cognitive functions were not related to SEP results.