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Bilateral hip heterotopic ossification with sciatic nerve compression on a paediatric patient-An individualized
João Pedro Gouveia Nóbrega1, Pedro Jordão2, Joana Arcângelo2
1Department of Orthopaedics, Hospital Dr. Nélio Mendonça, Funchal 9000-243, Portugal. joaonobrega@campus.ul.pt.
Background:
Neurogenic heterotopic ossification is an acquired serious complication described in patients with central nervous system disorders and defined by bone formation in non-osseous tissue.
Case Summary:
We present an unusual case of a 13-yr-old boy presenting with hip pain and severe gait impairment 5 mo after the diagnosis of hemiplegia following a spontaneous intracerebral haemorrhage. Computed tomography revealed bilateral heterotopic ossification of both the paretic and the non-paretic limbs, with entrapment of the sciatic nerve. The choice of surgical or nonsurgical management of such patients depends on the timing of diagnosis, the symptoms, and the extent of maturation of the ossified lesions. Surgical resection remains the only treatment with proven, evidence-based effectiveness. The choice of surgical approach largely depends on the location of the ossified lesions.
Conclusion:
We believe the plane of dissection presented is a satisfactory option for resection of a posteromedial mass and sciatic nerve release.
