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Post-traumatic heterotopic ossification in front of the ankle joint for 23 years:A case report and review of literature

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World Journal of Clinical Cases 2023年第1期11卷 193-200页

作者： Zheng Xu Zhou-Zhou Rao Zhong-Wen Tang Zhen-Qi Song Ming Zeng Hao-Li Gong Jie Wen Department of Pediatric Orthopedics Hunan Provincial People's HospitalThe First Affiliated Hospital of Hunan Normal UniversityChangsha 410013Hunan ProvinceChina Key Laboratory of Translational Cancer Stem Cell Research Department of PhysiologyHunan Normal University School of MedicineChangsha 410013Hunan ProvinceChina Department of Anatomy Hunan Normal University school of MedicineChangsha 410013HunanChina

BACKGROUND heterotopic ossification(HO)refers to the formation of new bone in non-skeletal tissues such as muscles,tendons or other soft *** muscle and soft tissue injury often lead to the formation of ***,anterior HO of the ankle is rarely *** SUMMARY We report a patient with massive HO in front of the ankle joint for 23 *** 1998,the patient was injured by a falling object on the right lower extremity,which gradually formed a massive heterotopic bone change in the right calf and dorsum of the *** patient did not develop gradual ankle function limitations until nearly 36 mo ago,and underwent resection of *** after 23 years and resection of HO,the ankle joint was still able to *** It is recommended that the orthopedist should be aware of HO and distinguish it from bone tumor.

关键词： heterotopic ossification Post-traumatic Ankle joint Case report

A Systems Biology Approach for Studying heterotopic ossification： Proteomic Analysis of Clinical Serum and Tissue Samples

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Genomics, Proteomics & Bioinformatics 2018年第3期16卷 212-220页

作者： Erin L. Crowgey Jennifer T. Wyffels Patrick M. Osborn Thomas T. Wood Laura E. Edsberg Nemours Biomedical Research Nemours Alfred I. duPont Hospital for Children Wilmington DE 19803 USA Natural and Health Sciences Researeh Center Center for Wound Healing Research Daemen College Amherst NY 14226 USA Department of Computer and Information Sciences Center for Bioinformatics and Computational Biology University of Delaware Newark DE 19711 USA San Antonio Military Medical Center San Antonio TX 78219 USA

heterotopic ossification （HO） refers to the abnormal formation of bone in soft tissue. Although some of the underlying processes of HO have been described, there are currently no clinical tests using validated biomarkers for predicting HO formation. As such, the diagnosis is made radiographically after HO has formed. To identify potential and novel biomarkers for HO, we used isobaric tags for relative and absolute quantitation （iTRAQ） and high-throughput antibody arrays to produce a semi-quantitative proteomics survey of serum and tissue from subjects with （HO ＋） and without （HO-） heterotopic ossification. The resulting data were then analyzed using a systems biology approach. We found that serum samples from subjects experiencing traumatic injuries with resulting HO have a different proteomic expression controls. Subsequent quantitative ELISA identified profile compared to those from the matched five blood serum proteins that were differentially regulated between the HO-- and HO- groups. Compared to HO- samples, the amount of insulin-like growth factor I （IGF1） was up-regulated in HO＋ samples, whereas a lower amount of osteopontin （OPN）, myeloperoxidase （MPO）, runt-related transcription factor 2 （RUNX2）,and growth differentiation factor 2 or bone morphogenetic protein 9 （BMP-9） was found in HO ＋ samples （Welch two sample t-test; P 〈 0.05）. These proteins, in combination with potential serum biomarkers previously reported, are key candidates for a serum diagnostic panel that may enable early detection of HO prior to radiographic and clinical manifestations.

关键词： heterotopic ossification Proteomics Runt-related transcriptionfactor 2 Extracellular matrixorganization Keratinization

Post-laparotomy heterotopic ossification of the xiphoid process: A case report

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World Journal of Clinical Cases 2023年第36期11卷 8568-8573页

作者： Seung Soo Lee Department of Surgery Kyungpook National University HospitalDaegu 41944South Korea Department of Surgery School of MedicineKyungpook National UniversityDaegu 41944South Korea

BACKGROUND heterotopic ossification(HO)represents all types of extraskeletal ossification in the *** occurs in various areas,including the skin,subcutaneous tissue,muscle,and *** excision is recommended for symptomatic *** radiotherapy,oral nonsteroidal anti-inflammatory drugs,and topical sealants,such as bone wax,have been recommended as preventive *** HO is rare in occurrence,these recommendations are based on personal experiences,and there is a lack of information on individualized treatments depending on its *** SUMMARY A 62-year-old male was admitted for symptomatic HO along a laparotomy *** excision was performed for an 11 cm-sized ossification originating from the xiphoid process,and bone wax was applied to the excisional ***,the surgical wound failed to *** several weeks of saline-soaked gauze dressing,delayed wound closure was *** patient was finally discharged eight weeks after the *** HO can occur in various areas of the body,a treatment strategy that may be effective for some may not be for *** wax has been used as a topical sealant over excisional margins in the shoulder,elbow,and temporomandibular ***,in our case,its application on an abdominal surgical wound delayed its primary healing *** valuable lesson was that,when choosing a treatment method for HO based on available research data,its location must be *** Complete excision should be the priority treatment option for symptomatic HO along the laparotomy *** wax application is not *** Tip:heterotopic ossification(HO)represents all types of extraskeletal ossification,and occurs in various areas,including the skin,muscle,and *** are some suggested treatment and preventive approaches for symptomatic HO,which include surgical excision and preventive measures such as postoperative radiotherapy,oral nonsteroidal anti-inflam-matory drug

关键词： heterotopic ossification Joints Laparotomy Waxes Wound healing Case report

Bilateral hip heterotopic ossification with sciatic nerve compression on a paediatric patient–An individualized surgical approach: A case report

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World Journal of Orthopedics 2022年第8期13卷 768-774页

作者： João Pedro Gouveia Nóbrega Pedro Jordão Joana Arcângelo Department of Orthopaedics Hospital Dr.Nélio MendonçaFunchal 9000-243Portugal Department of Orthopaedics Hospital Dona EstefâniaLisboa 1169-045Portugal

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 *** 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 *** tomography revealed bilateral heterotopic ossification of both the paretic and the non-paretic limbs,with entrapment of the sciatic *** 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 *** resection remains the only treatment with proven,evidence-based *** choice of surgical approach largely depends on the location of the ossified *** We believe the plane of dissection presented is a satisfactory option for resection of a posteromedial mass and sciatic nerve release.

关键词： Hip heterotopic ossification Pediatrics Orthopedics Ressection surgery Case report

Incidence and risk factors analysis of heterotopic ossification after cervical disc replacement

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Chinese Medical Journal 2014年第22期127卷 3871-3875页

作者： Qi Min Chen Huajiang Cao Peng Tian Ye Yuan Wen Department of Spine Surgery Changzheng Orthopedics HospitalSecond Military Medical University Shanghai 200003 China

Background Cervical disc replacement （CDR） as a substitute for traditional fusion surgery has been widely used in treating degenerative cervical disc *** objectives of this study were to assess the clinical and radiological findings for patients with heterotopic ossification （HO） following CDR and to detect the risk factors of HO after *** A total of 125 patients with symptomatic cervical single-or double-level disc diseases,who underwent CDR procedure with Discover prosthesis in Department of Spine Surgery,Changzheng Orthopedics Hospital from March 2009 to March 2011,were enrolled in this retrospective *** of HO was defined by the McAfee classification on cervical lateral X-rays in this *** vertebral ratio （PVR） was used to determine the matching degree between the cervical disc prosthesis and cervical *** regression analyses were performed to determine the risk factors of *** evaluated for their association with HO occurrence included age,gender,high-intensity signal in spinal cord,preoperative range of motion （ROM）,postoperative ROM,operation level number,and *** Mean follow-up time was （26.4±5.8） *** the patients had significant symptoms and neurological function improvements during the follow-up *** ROM of the operated segment from the preoperative period to the last follow-up was relatively well *** rate of HO in this cohort of patients,who underwent Discover disc,was 27.92％ per surgical level and 24.8％ per patient by the last *** were 19 patients （19.79％） with HO in the single-level group while 12 patients （41.38％） in the double-level *** We identified preoperative high-intensity signal in spinal cord,postoperative ROM of surgical level,number of operation level,and PVR as significant risk factors for postoperative HO occurrence.

关键词： cervical disc replacement heterotopic ossification risk factors

Non-Traumatic Intracranial heterotopic ossification: A Case from Turkey

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Forensic Medicine and Anatomy Research 2016年第1期4卷 17-21页

作者： Mehmet Hanifi Kokacya Hasan Gökçe Zeynel Abidin Taş Dua Sümeyra Demirkıran Muhammet Mustafa Arslan Department of Psychiatry Faculty of Medicine Mustafa Kemal University Hatay Turkey Department of Pathology Faculty of Medicine Inonü University Malatya Turkey Department of Pathology Faculty of Medicine Mustafa Kemal University Hatay Turkey Department of Forensic Medicine Faculty of Medicine Mustafa Kemal University Hatay Turkey

heterotopic ossification (HO) is the abnormal, non-neoplastic presence of lamellar bone in soft tissue. The ectopic formation of lamellar bone in non-osseus tissues secondary to traumatic injuries of the spinal cord or the brain is defined as Neurogenic HO. The pathophysiology of HO is not clear. But several theories like overactive humoral mechanisms after fracture healing, imbalance of pro-osteoinductive and anti-osteoinductive mediators located on the soft tissues and gene mutations in such as bone morphogenetic proteins-4 (BMP-4) are proposed. Casualty factors leading to increased risk of HO include older age, blast mechanism of injury, location of injury and traumatic brain injury. The aim of this paper is to demonstrate a case of HO located in the brain without history of trauma or any other risk factors.

关键词： heterotopic ossification Autopsy Traumatic Brain Injury

The roles of matrix vesicles in bone formation and heterotopic ossification

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The roles of matrix vesicles in bone formation and heterotop...

heterotopic mesenteric ossification caused by trauma:A case report

第八届全国医学生物化学与分子生物学第五届全国临床应用生物化学与分子生物学2013华东六省一市生物化学与分子生物学联合学术研讨会

作者： Pinglan Ge Yazhou Cui Jing Luan Xiaoyan Zhou Jinxiang Han Key Laboratory for Rare Disease Research of Shandong Province

In normal and healthy individuals,bone formation is normally limited to the specialized tissues,the skeleton and the dentition which forms through endochondral ossification or intramembranous *** these hard tissues,bone formation is tightly controlled both in growth and development and in normal adult *** contrast,heterotopic ossification is a pathological condition in which osteogenesis occurs outside of the skeleton,within soft tissues of the ***,the resulting extraskeletal bone is qualitatively normal endochondral or intramembranous bone,and develops through processes that parallel the events that occur during normal embryonic bone and skeletal formation,and also in bone regeneration during fracture *** increasing evidence supports the contention that the mechanisms of soft tissue ossification are similar to those seen in normal bone *** particular,matrix vesicles(MVs),small(20-200 nm) membrane particles,probably play a prominent role in mineral deposition and skeletal *** small particles are budded off from the plasma membrane of chondrocytes,osteoblasts,and odontoblasts prior to the onset of matrix mineralization and are released into the pre-mineralized organic *** perform specialized roles in initiating matrix mineralization,which regulate the Pi/PPi ratio in the intracellular and extracellular fluid,manage mineral nucleation for hydroxylapatite(HA),control calcium and Pi ion homeostasis,and interact with the surrounding ECM to direct HA localization and *** mechanisms involved in the ossification of mineralized tissues have been under investigation for many years and much progress has been made in this *** how matrix vesicles function in normal ossification and the evidence for their participation in pathologic ossification remains to be further researched and *** purpose of this study is to explore the mechanisms of MVs in hard tissue mineralization and then t

关键词： bone formation heterotopic ossification matrix vesicles mineralization hydroxylapatite

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World Journal of Gastrointestinal Endoscopy 2024年第8期16卷 494-499页

作者： Bi-Fang Zhang Jiang Liu Shuai Zhang Ling Chen Jia-Zheng Lu Ming-Qing Zhang Department of Gastroenterology The 909th HospitalSchool of MedicineXiamen UniversityZhangzhou 363000Fujian ProvinceChina

BACKGROUND heterotopic mesenteric ossification(HMO)is a clinically rare condition characterized by the formation of bone tissue in the *** worldwide reporting of such cases is limited to just over 70 instances in the medical *** etiology of HMO remains unclear,but the disease is possibly induced by mechanical trauma,ischemia,or intra-left lower quadrant abdominal infection,leading to the differentiation of mesenchymal stem cells into ***,we present a rare case of HMO that occurred in a 34-year-old male,who presented with left lower quadrant abdominal *** SUMMARY We report the case of a 34-year-old male patient who presented with left lower abdominal pain following trauma to the left lower *** subsequently underwent surgical treatment,and the postoperative pathological diagnosis was *** We believe that although there is limited literature and research on HMO,when patients with a history of trauma or surgery to the left lower abdomen present with corresponding imaging findings,clinicians should be vigilant in distinguishing this condition and promptly selecting appropriate diagnostic and therapeutic interventions.

关键词： Abdominal injuries heterotopic ossification Mesentery Abdominal pain Case report

Elevated Cobalt, Chromium and Molybdenum Levels in Peripheral Blood Have No Effect on the Development of heterotopic ossifications after Metal-on-Metal Total Hip Arthroplasty

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Journal of Biomedical Science and Engineering 2016年第1期9卷 25-40页

作者： Alexander J. Pfister Karl-Heinz Widmer Niklaus F. Friederich Martin Majewski Department of Anaesthesiology Hospital of Bülach Bülach Switzerland Department of Orthopaedic Surgery and Traumatology Hospital of Schaffhausen Schaffhausen Switzerland Department of Orthopaedic Surgery and Traumatology University of Basel Basel Switzerland

Metal debris from metal-on-metal (MoM) total hip arthroplasties (THA) has been suspected to cause periprosthetic heterotopic ossifications (HO). We determined the influence of disseminated cobalt, chromium and molybdenum on the development of HO. Native blood samples from patients with 86 high-carbon and 16 low-carbon Co28Cr6Mo articulations were analysed by high-resolution inductively coupled plasma mass-spectrometry (HR ICP-MS). The results revealed that high-carbon metal-on-metal articulations showed lower metal blood levels (Co 1.03 to 1.60 μg/l, Cr 0.77 to 0.88 μg/l, Mo 0.45 to 0.56 μg/l) whereas low-carbon articulations achieved higher metal blood levels (Co 2.59 to 6.85 μg/l, Cr 1.25 to 3.55 μg/l, Mo 0.45 to 0.64 μg/l), but no correlation between metal ion blood level or carbon content and the development of HO could be found in these MoM articulations. Hence, metal debris from MoM articulation does not stimulate heterotopic bone formation despite other well-known local reactions.

关键词： Wear Total Hip Arthroplasty Cobalt Chromium Molybdenum heterotopic ossification