Abstract
A case of extensive heterotopic ossification involving the left hip in a 16 year old girl who sustained non traumatic spinal paralysis at T4 ASIA scale A. This case demonstrates the practical difficulties facing clinicians involved in the rehabilitation of this paraplegic patient who required intervention before full maturation of her left hip heterotopic ossification (HO). The patient was developing a rapidly progressive fixed scoliosis and severe difficulty in achieving a proper seating posture. In addition there was difficulty with the application of a suitable orthosis to try and limit the progression of scoliosis as a result of the HO. Discussants will comment on heterotopic ossification in general and the course of action in this particular case.
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References
Schaeffer MA, Sosner J . Heterotopic ossification: Treatment of established bone with radiation therapy Arch Phys Med Rehabil 1995 76: 284–286
Subbarao JV, Nemchausky BA, Gratzer M . Resection of heterotopic ossification and Didronel therapy-regaining wheelchair independence in the spinal cord injured patient J Am Paraplegia Soc 1987 10: 3–7
Banovac K, Gonzalez F, Wade N, Bowker JJ . Intravenous disodium etidronate therapy in spinal cord injury patients with heterotopic ossification Paraplegia 1993 31: 660–666
Subbarao JV, Garrison SJ . Heterotopic ossification: Diagnosis Management current concepts controversies J Spinal Cord Medicine 1999 22: 273–283
Subbarao JV . Pseudoarthrosis in heterotopic ossification in spinal cord injured patients Am J Phys Med Rehabil 1990 69: 88–90
Schmidt SA et al.. The use of Indomethacin to prevent the formation of heterotopic bone after total hip replacement J Bone Joint Surg 1988 70A: 834–838
Banovac K, Williams JM, Patrick LD, Haniff YM . Prevention of heterotopic ossification after spinal cord injury with Indomethacin Spinal Cord 2001 39: 370–374
Hamilton Lal S, Heinemann BB, Betts A . Risk factors for heterotopic ossification in spinal cord injury Arch Phys Med Rehabil 1989 70: 387–390
Dai L . Heterotopic ossification of the hip after spinal cord injury Chin Med J (Engl) 1998 111: 1099–1101
Garland DE et al. Spinal cord insults and heterotopic ossification in the pediatric population Clin Orthop 1989 245: 303–310
Taly AB et al. Hererotopic ossification in non-traumatic myelopathies Spinal Cord 1999 37: 47–49
Snoecx N, De-Muynck M, Van Laere M . Association between muscle truama and heterotopic ossification in spinal cord injured patients: reflections on their casual relationship and the diagnostic value of ultrasonagraphy Paraplegia 1995 33: 464–468
Stover AL, Hataway CJ, Zeiger HE . Heterotopic ossification in spinal cord injured patients Arch Phys Med Rehabil 1975 56: 199–204
Freed JH, Hahn H, Menter R, Dillon T . The use of the three phase bone scan in the early diagnosis of heterotopic ossification (HO) and in the evaluation of Didronel therapy Paraplegia 1982 20: 208–216
Schurch B, Capaul M, Vallotton MB, Rossier AB . Prostaglandin E2 measurements: their value in the early diagnosis of heterotopic ossification in spinal cord injury patients Arch Phy Med Rehabil 1997 78: 687–691
Kim SW, Wu SY, Kim RC . Computerised quantiative radionuclide assessment of heterotopic ossification in spinal cord injury patients Paraplegia 1992 30: 803–807
Banovac K, Gonzalez F . Evaluation and management of heterotopic ossification in patients with spinal cord injury Spinal Cord 1997 35: 158–162
Freebourn TM, Barber DB, Able AC . The treatment of immature heterotopic ossification in spinal cord injury with combination surgery, radiation therapy and NSAID Spinal Cord 1999 37: 50–53
Acknowledgements
Publication of this article has been supported in part by a grant from Procter & Gamble Pharmaceutical Limited. My gratitude to Marie Jones, Department of Medical Photography, Salisbury District Hospital, Salisbury for her technical support in the production of this paper.
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Jamil, F., Subbarao, J., Banaovac, K. et al. Management of immature heterotopic ossification (HO) of the hip. Spinal Cord 40, 388–395 (2002). https://doi.org/10.1038/sj.sc.3101305
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DOI: https://doi.org/10.1038/sj.sc.3101305


