Periarticular ossifications in paraplegics most frequently occur around the hip. Typically, the newly formed bone limits foremost flexion. The ossification takes place in the connective tissues of the muscle; its etiology and pathogenesis remain to be elucidated. In general, neither the joint nor its capsule are involved in the process of ossification. The incidence of HO in paraplegics is said to 18% of clinically relevant ossifications. There is a general consensus that surgery should only be performed after maturation of the ossification. The determination of alkaline phosphatase and a bone scan are used for assessment of osteogenic activity.
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