Department of Burns and Plastic Surgery, the First Affiliate Hospital of Guangxi Medical University, Nanning 530021, Guangxi, People's Republic of China.
J Wound Care. 2024 Mar 1;33(Sup3a):lxix-lxxiii. doi: 10.12968/jowc.2024.33.Sup3a.lxix.
Neurogenic heterotopic ossification (NHO) is widely recognised as an aberrant bone formation in soft tissue following central nervous system injury. It is most frequently associated with pain and limited movement, especially in the hip. However, it may be neglected in patients with paraplegia with a pressure ulcer (PU). We report the case of an 18-year-old male patient who presented with a hard-to-heal ischial tuberosity PU and who had undergone three operations at other hospitals during the previous six months, which had failed to repair the PU. There was a history of paraplegia as a consequence of spinal cord injury two years previously. Computed tomography and three-dimensional reconstruction showed massive heterotopic ossification (HO) in the wound bed and around the right hip. Histological findings were consistent with a diagnosis of HO. The HO around the wound was completely excised, negative pressure wound therapy was used to promote granulation, and a gluteus maximus musculocutaneous flap was used to cover the wound. We conclude that for patients with paraplegia, with a hard-to-heal PU, it should be determined whether it is associated with NHO. Surgical resection of HO surrounding the wound and improving the microcirculation are critical for repair and reconstruction of these PUs.
神经源性异位骨化（NHO）是中枢神经系统损伤后软组织中异常骨形成的一种广泛认识的疾病。它最常与疼痛和活动受限相关，特别是在髋关节。然而，在伴有压疮（PU）的截瘫患者中，可能会被忽视。我们报告了一例 18 岁男性患者的病例，他患有难以愈合的坐骨结节 P U ，并在过去六个月内在其他医院接受了三次手术，但未能修复 P U 。两年前因脊髓损伤导致截瘫。计算机断层扫描和三维重建显示伤口床和右侧臀部有大量异位骨化（HO）。组织学检查结果符合 HO 的诊断。HO 围绕伤口完全切除，使用负压伤口治疗促进肉芽形成，并使用臀大肌皮瓣覆盖伤口。我们得出结论，对于截瘫患者，对于难以愈合的 P U ，应确定其是否与 NHO 相关。切除伤口周围的 HO 并改善微循环对于这些 P U 的修复和重建至关重要。
