Heterotopic Ossification after Closed Femoral Nailing
Suthat Juengteerapanich MD* Pacharapol Udomkiat MD*, Banchong Mahaisavariya MD*
Affiliation : * Department of Orthopaedics Surgery, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
Background : Heterotopic ossification is defined as pathological bone formation in soft tissue, it usually occurs postoperatively
and varies in amount from faint to massive ossification, which are frequently asymptomatic. The cause of heterotopic
ossification is unknown, but it occurs more commonly after the procedure, in which considerable bone and soft tissue are
dissected extensively. The heterotopic ossification in the abductor region of the hip following closed femoral nailing has rarely
been documented.
Objective : To assess the prevalence and type of heterotopic ossification after closed antegrade femoral nailing.
Material and Method: A retrospective study was performed in patients who underwent closed antegrade femoral nailing. The
occurrence of heterotopic bone was assessed by reviewing of the series of the follow-up films in this group of patients with
sufficient duration of at least after 6 months post-operation. The size and extent of the heterotopic ossification were measured
and graded according to Brumback classification.
Results : From 100 patients who were completely followed-up. There were 54 cases (54%) presented with heterotopic
ossification. The heterotopic ossification are classified as grade I in 16 cases (16%), grade II in 13 cases (13%), grade III in
24 cases (24%) and grade IV in 1 case (1%). There was a significant different between the prevelence of heterotopic
ossification in patients with trochnateric fractures when compared to patients with femoral shaft fractures (p-value < 0.05).
Keywords : Ossification, Nailing, Femur, Fracture
