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Postoperative heterotopic ossification in the child with cerebral palsy: three case reports
M Lee1, M A Alexander, F Miller
1Alfred I. duPont Institute, Wilmington, DE 19899.
Archives of Physical Medicine and Rehabilitation
|March 1, 1992
Insights
Children with cerebral palsy experienced irritability after surgery, later diagnosed with heterotopic ossification. This bone growth occurred around the hip following hip surgery or spinal fusion.
Area of Science:
- Orthopedic Surgery
- Pediatric Neurology
- Developmental Disabilities
Background:
- Cerebral palsy (CP) is a group of movement disorders that affect muscle tone and posture.
- Surgical interventions are common in managing CP-related orthopedic issues.
- Mental retardation can be a co-occurring condition with cerebral palsy.
Observation:
- Three pediatric patients with cerebral palsy and mental retardation exhibited new-onset irritability post-operatively.
- The irritability was a precursor to the diagnosis of heterotopic ossification.
- Clinical presentation included significant discomfort and behavioral changes.
Findings:
- Heterotopic ossification (HO) was confirmed in all three children.
- HO developed in the hip region in all cases.
- Two patients developed HO after bilateral adductor release surgery; one developed HO after spinal fusion.
Implications:
- Post-surgical heterotopic ossification is a potential complication in children with cerebral palsy.
- Irritability may be an early indicator of HO in this population.
- Further research is needed to understand the pathophysiology and prevention strategies for HO in pediatric CP patients.
Abstract:
Three children with cerebral palsy and mental retardation showed irritability after surgical procedures. They were subsequently diagnosed as having heterotopic ossification. Heterotopic ossification developed around the hip in all cases--two after bilateral adductor releases at the operative site and the third after spinal fusion at a site unrelated to the surgery.