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Heterotope Ossifikation

Von der Ätiologie zur aktuellen Therapie

Heterotopic ossification – from the aetiology to the current management

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Zusammenfassung

Heterotope Ossifikationen werden als abnorme Bildung von Knochen in Weichteilgeweben definiert. Man unterscheidet die erworbene von den angeborenen Formen. Die erworbene Form, deren Pathogenese weitgehend ungeklärt ist, wird häufig bei Patienten mit Schädel-Hirn-Trauma, Rückenmarkverletzung, Trauma des Bewegungsapparats oder nach Verbrennungen beobachtet. Klinisch präsentieren sich die heterotopen Ossifikationen häufig symptomfrei, im Initialstadium mit unspezifischen Symptomen, ausgeprägte Formen können jedoch zu schwerwiegenden Funktionseinschränkungen führen. Zur Diagnosesicherung wird insbesondere die Knochenszintigraphie verwendet. Lokale Bestrahlung und nichtsteroidale Antiphlogistika bilden die klassischen Therapie- und Prophylaxeoptionen. In fortgeschrittenen Stadien kann eine chirurgische Resektion notwendig sein.

Abstract

Heterotopic ossifications (HO) are defined as the abnormal formation of bone in soft tissues. It can be classified into acquired and congenital forms. The acquired form, of which the pathogenesis is not fully understood, is often diagnosed in patients with traumatic brain injury, spinal cord injury, musculo-skeletal trauma or injuries associated with burns. HO presents itself mostly asymptomatically, the symptoms of the initial stadium are often unspecific; however, severe forms can lead to severe disability. Imaging techniques, foremost bone szintigraphy, are mostly used for verification of the diagnosis. Local radiotherapy and nonsteroidal anti-inflammatory drugs are the classical therapeutic and prophylactic options. In advanced stages, surgical resection may be required.

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Danksagung

Dr. Gautschi wurde unterstützt mit einem Forschungsbeitrag der Novartis Stiftung, früher Ciba-Geigy Jubiläumsstiftung, und der Freiwilligen Akademischen Gesellschaft Basel, Schweiz. Wir danken Frau Leona von Schnakenburg für die kritische Durchsicht des Manuskripts.

Interessenkonflikt

Es besteht kein Interessenkonflikt. Dr. Gautschi wurde unterstützt mit einem Forschungsbeitrag der Novartis Stiftung, früher Ciba-Geigy Jubiläumsstiftung, und der Freiwilligen Akademischen Gesellschaft Basel, Schweiz.

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Authors and Affiliations

  1. Klinik für Neurochirurgie, Kantonsspital St. Gallen, Rorschacher Strasse 95, 9007, St. Gallen, Schweiz

    O.P. Gautschi

  2. Department of Orthopaedic and Trauma Surgery, Royal Perth Hospital, Perth, Australia

    O.P. Gautschi, D. Cadosch, S. Bauer & R. Zellweger

  3. School of Anatomy and Human Biology, University of Western Australia, Crawley , Australia

    O.P. Gautschi, D. Cadosch, L. Filgueira & R. Zellweger

Authors
  1. O.P. Gautschi
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  2. D. Cadosch
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  3. S. Bauer
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  4. L. Filgueira
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  5. R. Zellweger
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Correspondence to O.P. Gautschi.

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Gautschi, O., Cadosch, D., Bauer, S. et al. Heterotope Ossifikation. Unfallchirurg 111, 523–534 (2008). https://doi.org/10.1007/s00113-008-1475-z

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