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Partial Femoral Diaphysectomy With Vastus Lateralis Interposition in a Paraplegic Patient With Severely Debilitating Hip Ankylosis: Low Risks and High Gains?

We present the case of a 56-year-old male unable to sit because of an ankylosed right hip. This ankylosis originated from combined neurogenic heterotopic ossifications (NHO) and traumatic heterotopic ossifications (THO) as a result of a road traffic accident. Because of multiple ossifications, the p...

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Autores principales: Follet, Louis, Moke, Lieven, Ghijselings, Stijn, Wafa, Hazem, Vles, Georges
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10072178/
https://www.ncbi.nlm.nih.gov/pubmed/37025713
http://dx.doi.org/10.7759/cureus.35786
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author Follet, Louis
Moke, Lieven
Ghijselings, Stijn
Wafa, Hazem
Vles, Georges
author_facet Follet, Louis
Moke, Lieven
Ghijselings, Stijn
Wafa, Hazem
Vles, Georges
author_sort Follet, Louis
collection PubMed
description We present the case of a 56-year-old male unable to sit because of an ankylosed right hip. This ankylosis originated from combined neurogenic heterotopic ossifications (NHO) and traumatic heterotopic ossifications (THO) as a result of a road traffic accident. Because of multiple ossifications, the proximity of neurovascular structures, and chronic pressure ulcers, a resection was deemed unsafe. We opted for a new articulation distal to the ossifications in unstained tissue. A partial femoral diaphysectomy was performed just distal of the lesser trochanter. and the vastus lateralis was rotated in the new articulation. Postoperatively, the patient was able to sit as his hip could flex again. A partial femoral diaphysectomy with vastus lateralis interposition flap appears to be a valid option in paraplegic patients with extensive heterotopic ossifications (HO) in close proximity to neurovascular structures with a low risk of complications and high gain in hip mobility.
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spelling pubmed-100721782023-04-05 Partial Femoral Diaphysectomy With Vastus Lateralis Interposition in a Paraplegic Patient With Severely Debilitating Hip Ankylosis: Low Risks and High Gains? Follet, Louis Moke, Lieven Ghijselings, Stijn Wafa, Hazem Vles, Georges Cureus Physical Medicine & Rehabilitation We present the case of a 56-year-old male unable to sit because of an ankylosed right hip. This ankylosis originated from combined neurogenic heterotopic ossifications (NHO) and traumatic heterotopic ossifications (THO) as a result of a road traffic accident. Because of multiple ossifications, the proximity of neurovascular structures, and chronic pressure ulcers, a resection was deemed unsafe. We opted for a new articulation distal to the ossifications in unstained tissue. A partial femoral diaphysectomy was performed just distal of the lesser trochanter. and the vastus lateralis was rotated in the new articulation. Postoperatively, the patient was able to sit as his hip could flex again. A partial femoral diaphysectomy with vastus lateralis interposition flap appears to be a valid option in paraplegic patients with extensive heterotopic ossifications (HO) in close proximity to neurovascular structures with a low risk of complications and high gain in hip mobility. Cureus 2023-03-05 /pmc/articles/PMC10072178/ /pubmed/37025713 http://dx.doi.org/10.7759/cureus.35786 Text en Copyright © 2023, Follet et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Physical Medicine & Rehabilitation
Follet, Louis
Moke, Lieven
Ghijselings, Stijn
Wafa, Hazem
Vles, Georges
Partial Femoral Diaphysectomy With Vastus Lateralis Interposition in a Paraplegic Patient With Severely Debilitating Hip Ankylosis: Low Risks and High Gains?
title Partial Femoral Diaphysectomy With Vastus Lateralis Interposition in a Paraplegic Patient With Severely Debilitating Hip Ankylosis: Low Risks and High Gains?
title_full Partial Femoral Diaphysectomy With Vastus Lateralis Interposition in a Paraplegic Patient With Severely Debilitating Hip Ankylosis: Low Risks and High Gains?
title_fullStr Partial Femoral Diaphysectomy With Vastus Lateralis Interposition in a Paraplegic Patient With Severely Debilitating Hip Ankylosis: Low Risks and High Gains?
title_full_unstemmed Partial Femoral Diaphysectomy With Vastus Lateralis Interposition in a Paraplegic Patient With Severely Debilitating Hip Ankylosis: Low Risks and High Gains?
title_short Partial Femoral Diaphysectomy With Vastus Lateralis Interposition in a Paraplegic Patient With Severely Debilitating Hip Ankylosis: Low Risks and High Gains?
title_sort partial femoral diaphysectomy with vastus lateralis interposition in a paraplegic patient with severely debilitating hip ankylosis: low risks and high gains?
topic Physical Medicine & Rehabilitation
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10072178/
https://www.ncbi.nlm.nih.gov/pubmed/37025713
http://dx.doi.org/10.7759/cureus.35786
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