Follet Louis, Moke Lieven, Ghijselings Stijn, Wafa Hazem, Vles Georges
Orthopedics, University Hospitals Leuven, Leuven, BEL.
Spine Surgery, University Hospitals Leuven, Leuven, BEL.
Cureus. 2023 Mar 5;15(3):e35786. doi: 10.7759/cureus.35786. eCollection 2023 Mar.
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.
我们报告一例56岁男性患者，因右髋关节强直而无法坐下。这种强直源于道路交通事故导致的神经源性异位骨化（NHO）和创伤性异位骨化（THO）合并。由于多处骨化、神经血管结构临近以及慢性压疮，切除手术被认为不安全。我们选择在未染色组织中骨化部位远端进行新的关节形成术。在小转子远端进行了部分股骨干切除术，并将股外侧肌旋转至新关节处。术后，患者能够坐下，因为其髋关节能够再次屈曲。对于截瘫患者，当广泛的异位骨化（HO）靠近神经血管结构且并发症风险低、髋关节活动度改善显著时，采用股外侧肌插入瓣的部分股骨干切除术似乎是一种有效的选择。
