Treatment of heterotopic ossification of the hip with use of a plaster cast: case report

Heterotopic ossification can be defined as the formation of bone in tissues that have no ossification properties, such as in muscles and connective tissue of a periarticular region, without invasion of the joint capsule. This pathology usually has a benign course, but it can cause a reduction in the range of joint movement and hamper the rehabilitation process. Its etiology is still unknown and it usually is originated from posttraumatic complications, affecting 10–20% of patients with traumatic brain injury. Among its clinical manifestations, it may present pain and limitation of joint movement, heat, edema, and local flushing. In some cases, it can present moderate fever, severe spasticity, and even ankylosis in more advanced stages of the disease. Treatment is based on resection of the ossification, with adjuvant measures such as non-steroidal anti-inflammatory drugs, bisphosphonate, radiotherapy, and physical therapy. None of these methods currently have a precise recommendation regarding dose, quantity, or well-established protocols. Still, the best treatment is prevention. The objective of this report is to describe a case of heterotopic ossification in the hip after traumatic brain injury, presenting the clinical manifestations and discussing the treatment instituted with a long leg plaster cast.