Heterotopic ossification in the reaming tract of a percutaneous antegrade femoral nail: a case report

Journal of Medical Case Reports

Philip F Stahel¹  David J Hak¹  E Mark Hammerberg¹  Cyril Mauffrey¹  Sergiu Botolin¹ 

[1] Department of Orthopaedic Surgery, Denver Health Medical Center, University of Colorado, School of Medicine, 777 Bannock Street, Denver, CO, 80204, USA

关键词: Complication;    Femur fracture;    Femoral nailing;    Heterotopic ossification;   

Others  :  1181229
DOI  :  10.1186/1752-1947-7-90

 received in 2012-12-07, accepted in 2013-02-21,  发布年份 2013

【 摘 要 】

Introduction

Heterotopic ossification is a rare complication of musculoskeletal injuries, characterized by bone growth in soft tissues. Percutaneous antegrade intramedullary nailing represents the ‘gold standard’ for the treatment of femur shaft fractures. Minor bone growth is frequently seen around the proximal end of reamed femoral nails (so-called ‘callus caps’), which are asymptomatic and lack a therapeutic implication. The occurrence of excessive, symptomatic heterotopic ossification around the entry site of an antegrade femoral nail is rarely described in the literature.

Case presentation

We present the case of a 28-year-old Caucasian woman who developed extensive heterotopic ossification around the reaming seeds of a reamed femoral nail. She developed severe pain and significantly impaired range of motion of the hip joint, requiring revision surgery for heterotopic ossification resection and adjunctive local irradiation. She recovered full function of the hip and remained asymptomatic at her two-year follow-up appointment.

Conclusions

Severe heterotopic ossification represents a rare but potentially detrimental complication after percutaneous femoral nailing of femur shaft fractures. Diligent care during the reaming procedure, including placement of a trocar to protect from osteogenic seeding of the soft tissues, may help decrease the risk of developing heterotopic ossification after reamed antegrade femoral nailing.

【 授权许可】

   
2013 Botolin et al.; licensee BioMed Central Ltd.

【 图 表 】

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