Nóbrega JPG, Jordão P, Arcângelo J. Bilateral hip heterotopic ossification with sciatic nerve compression on a paediatric patient–An individualized surgical approach: A case report. World J Orthop 2022; 13(8): 768-774 [PMID: 36159619 DOI: 10.5312/wjo.v13.i8.768]
Corresponding Author of This Article
João Pedro Gouveia Nóbrega, MD, Surgeon, Department of Orthopaedics, Hospital Dr. Nélio Mendonça, Caminho do Arieiro nº46, Funchal 9000-243, Portugal. joaonobrega@campus.ul.pt
Research Domain of This Article
Orthopedics
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Orthop. Aug 18, 2022; 13(8): 768-774 Published online Aug 18, 2022. doi: 10.5312/wjo.v13.i8.768
Bilateral hip heterotopic ossification with sciatic nerve compression on a paediatric patient–An individualized surgical approach: A case report
João Pedro Gouveia Nóbrega, Pedro Jordão, Joana Arcângelo
João Pedro Gouveia Nóbrega, Department of Orthopaedics, Hospital Dr. Nélio Mendonça, Funchal 9000-243, Portugal
Pedro Jordão, Joana Arcângelo, Department of Orthopaedics, Hospital Dona Estefânia, Lisboa 1169-045, Portugal
Author contributions: In terms of the revision, the first author Nóbrega JPG has complemented the text with the reviewers’ requests and the other authors corrected and complemented the text.
Informed consent statement: The informed consent was signed and explained to the mother of this patient in portuguese language.
Conflict-of-interest statement: All authors report no relevant conflict of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: João Pedro Gouveia Nóbrega, MD, Surgeon, Department of Orthopaedics, Hospital Dr. Nélio Mendonça, Caminho do Arieiro nº46, Funchal 9000-243, Portugal. joaonobrega@campus.ul.pt
Received: September 5, 2021 Peer-review started: September 5, 2021 First decision: December 2, 2021 Revised: December 15, 2021 Accepted: July 18, 2022 Article in press: July 18, 2022 Published online: August 18, 2022
Abstract
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.
Core Tip: Rare case of a post-stroke bilateral neurogenic heterotopic ossification of the hip with sciatic nerve entrapment in a paediatric patient with an individualised surgical approach for resection and release of the sciatic nerve.
