Abstract：
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.
摘要：
神经源性异位骨化（NHO）被广泛认为是中枢神经系统损伤后软组织中的异常骨形成。它最常见的是疼痛和有限的运动，尤其是臀部.然而,在截瘫伴压疮（PU）的患者中可能会忽略它。我们报告了一名18岁的男性患者，该患者表现出难以治愈的坐骨结节PU，并且在过去六个月中在其他医院进行了三次手术，未能修复PU。两年前有脊髓损伤导致截瘫的病史。计算机断层扫描和三维重建显示伤口床和右髋周围有大量异位骨化（HO）。组织学发现与HO的诊断一致。伤口周围的HO被完全切除，负压伤口疗法用于促进肉芽形成，用臀大肌肌皮瓣覆盖伤口。我们得出结论，对于截瘫患者，用一个难以治愈的PU，应该确定它是否与NHO有关。手术切除伤口周围的HO并改善微循环对于这些PU的修复和重建至关重要。
