Case report: Surgical management of a rare colossally sized neurogenic heterotrophic ossificans in the hip

Abstract

A rare case of Neurogenic heterotrophic ossification in Hip region presented to our institute with gross clinical features involving global restriction of movement in the hip joint. The patient had sustained a head injury 9 months back due to road traffic accident. Initial radiographs revealed a bony mass in the left hip region from Anterior superior iliac spine to proximal shaft of femur. Later CT scan of hip revealed various facets of the condition, the expanse of the entire bony lesion was traced. A 10 x 10 x 4cm irregular bony mass was visualized in the left hip spanning the entire left hip joint. The extent of involvement of vastus muscles and gluteal muscles was still uncertain. After thorough pre operative planning the mass was excised and sent for histopathological examination. Complete range of movements were checked perioperatively after excision involving flexion, adduction abduction and rotations. The biopsy findings suggested that the specimen contained large osteoid seams with fibrocollagenous bands and striated muscle tissue suggestive of heterotrophic ossificans.