title: Gluteus minimus necrotic muscle debridement diminishes heterotopic ossification after acetabular fracture fixation.
abstract: OBJECTIVE
  The aetiology and pathogenesis of heterotopic ossification (HO) are still obscure. We evaluated the impact of necrotic gluteus minimus muscle (GMM) debridement on the formation of HO after operative treatment of posterior wall (PW) and associated transverse-posterior wall acetabular fracture (Tr/PW) fixations utilizing a Kocher-Langenbeck surgical exposure.
  
  
  METHODS
  Thirty-one consecutive patients with displaced PW or associated Tr/PW acetabular fracture-dislocations were operatively treated by a single surgeon using a Kocher-Langenbeck surgical exposure. Strict soft tissue technique was observed and self-retaining retractors were not used. Necrotic GMM was debrided in an attempt to diminish ectopic bone formation.
  
  
  RESULTS
  Twenty-nine patients were available for post-operative clinical and radiographic evaluations. HO occurred in 12 patients. Significant HO (Brooker class III or IV) was noted in only three patients (10%). There were no complications associated with debridement of necrotic GMM.
  
  
  CONCLUSIONS
  Necrotic GMM resection diminishes HO formation comparably to other reported series in which non-steroidal anti-inflammatory medications were used. Resection of the necrotic GMM from the zone of injury has proved to be an efficient and safe method of preventing significant HO in patients after operative fixation of PW and associated Tr/PW acetabular fractures treated through a Kocher-Langenbeck approach.
authors.affiliation: Orthopedic Department, Soroka Medical Center, Ben Gurion University of the Negev, Beer Sheeva, Israel.
authors.forename: Ehud M S
authors.initials: EM
authors.lastname: Rath
authors.forename: George V
authors.initials: GV
authors.lastname: Russell
authors.forename: William J
authors.initials: WJ
authors.lastname: Washington
authors.forename: M L Chip
authors.initials: ML
authors.lastname: Routt
mesh_terms: D000077:Acetabulum / Q000293:injuries*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002081:Buttocks; D003646:Debridement / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D005592:Fracture Fixation / Q000009:adverse effects* / Q000534:rehabilitation; D006801:Humans; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000473:pathology / Q000601:surgery*; D009336:Necrosis; D009999:Ossification, Heterotopic / Q000209:etiology / Q000517:prevention & control*