Heterotopic bone formation about the hip and unilateral decubitus ulcers in spinal cord injury

Of 131 patients having spinal cord injury who were admitted to the hospital for chronic symptoms over a two-year period, 62 (47 percent) developed heterotopic ossifications in hip muscles. Of these 62 cases, 51 were unilateral. In 83 (63 percent) of the 131 patients, decubitus ulcers developed and these were unilateral in 71 cases. A high correlation between ulceration and heterotopic ossification was observed (phi = 0.69, P less than 0.001). Because heterotopy in the absence of ulceration was infrequent (less than 1 percent of cases), it appears that ossification and reduced mobility of a limb predipose to the development of the decubitus ulcer.