Cureus Journal of Medical Science
Author:
Keywords:
Science & Technology, Life Sciences & Biomedicine, Medicine, General & Internal, General & Internal Medicine, diaphysectomy, intercalated resection, hip ankylosis, traumatic heterotopic ossification, neurogenic, heterotopic ossification, HETEROTOPIC OSSIFICATION, RESECTION, neurogenic heterotopic ossification, 11 Medical and Health Sciences, 32 Biomedical and clinical sciences, 42 Health sciences
Abstract:
We present the case of a 56-year-old male unable to sit because of an ankylosed right hip. This ankylosis originated from combined neurogenic heterotopic ossifications (NHO) and traumatic heterotopic ossifications (THO) as a result of a road traffic accident. Because of multiple ossifications, the proximity of neurovascular structures, and chronic pressure ulcers, a resection was deemed unsafe. We opted for a new articulation distal to the ossifications in unstained tissue. A partial femoral diaphysectomy was performed just distal of the lesser trochanter. and the vastus lateralis was rotated in the new articulation. Postoperatively, the patient was able to sit as his hip could flex again. A partial femoral diaphysectomy with vastus lateralis interposition flap appears to be a valid option in paraplegic patients with extensive heterotopic ossifications (HO) in close proximity to neurovascular structures with a low risk of complications and high gain in hip mobility.