Vanden Bossche Luc, Vanderstraeten Guy
Department of Physical Medicine and Orthopaedic Surgery, Ghent University Hospital, B-9000 Ghent, Belgium.
J Rehabil Med. 2005 May;37(3):129-36. doi: 10.1080/16501970510027628.
Heterotopic ossification is defined as the presence of lamellar bone at locations where bone normally does not exist. The condition must be distinguished from metastatic calcifications, which mainly occur in hypercalcaemia, and dystrophic calcifications in tumours. It is a frequent complication following central nervous system disorders (brain injuries, tumours, encephalitis, spinal cord lesions), multiple injuries, hip surgery and burns. In addition to this acquired form, hereditary causes also exist, such as fibrodysplasia ossificans progressiva, progressive osseous heteroplasia and Albright's hereditary osteodystrophy. Although these conditions are extremely rare, they can provide useful information on the physiopathology of heterotopic ossification, and thus lead to novel and causal treatment modalities. Heterotopic ossification is no trivial complication. A limitation of the range of joint motion may have serious consequences for the daily functioning of people who are already severely incapacitated because of their original lesion. Increased contractures and spasticity, pressure ulcers and increasing pain further compromise the patient's capabilities. Consequently, we feel that attention should be paid to the pathogenesis and particularly the prevention and treatment of this disorder.
异位骨化的定义是在正常情况下不存在骨骼的部位出现板层骨。这种情况必须与主要发生在高钙血症中的转移性钙化以及肿瘤中的营养不良性钙化相区分。它是中枢神经系统疾病(脑损伤、肿瘤、脑炎、脊髓损伤)、多发伤、髋关节手术和烧伤后的常见并发症。除了这种后天形成的形式外,还存在遗传原因,如进行性骨化性纤维发育不良、进行性骨组织异常增生症和奥尔布赖特遗传性骨营养不良。尽管这些情况极为罕见,但它们可以为异位骨化的生理病理学提供有用信息,从而导致新的因果治疗方式。异位骨化并非微不足道的并发症。关节活动范围受限可能会对因原发损伤而已经严重丧失能力的人的日常功能产生严重后果。挛缩和痉挛加剧、压疮以及疼痛加剧会进一步损害患者的能力。因此,我们认为应该关注这种疾病的发病机制,尤其是预防和治疗。