[Surgical resection of heterotopic ossification after open reduction internal fixation of acetabular fractures].
OBJECTIVE
To evaluate the clinical effect of surgical resection of the severe heterotopic ossification (HO) after the open reduction internal fixation (ORIF) of acetabular fractures.


METHODS
Five cases of severe HO after the ORIF of acetabular fractures were treated by surgical resection from October 2005 to April 2007. All patients were male, the average age was 34 years (22 to 45 years). The average time of HO after ORIF of acetabular fractures was 14.2 months (3 to 30 months). The original surgical approaches were: Kocher-Langenbeck approach as 4, ilioinguinal combined K-L approach as 1. According to the Brooker classification, there were 4 patients with IV degree and 1 with III degree. The average total movement for all the 5 patients was 8 degrees. All patients received one time radiation therapy before or after operation, the dosage was 7-8 Gy. The surgical approach was Kocher-Langenbeck for all patients. During operation the nerve stimulator was used to explore the sciatic nerve and carefully protected it, resected all HO bone and removed all implants. For one patient, because of confusion between femoral head and acetabulum, total hip replacement were performed. The joint exercise (passively and actively) began from the second day after operation, and at the same time, all patients took the indomethacin to prevent the occurrence of HO.


RESULTS
All patients were followed up for 4 to 22 months. There was no recurrence of HO, the average total movement for all the 5 patients was 160 degrees.


CONCLUSIONS
Early surgical resection and combined with radiation and indomethacin for the severe HO after the ORIF of acetabular fractures can obtain excellent results.
Wu
Xin-Bao
XB
Department of Trauma and Orthopaedics, Fourth School of Medicine of Peking University, Beijing Jishuitan Hospital, Beijing 100035, China.
Yang
Ming-Hui
MH
Wang
Man-Yi
MY
Sun
Lin
L
Zhu
Shi-Wen
SW
Mao
Yu-Jiang
YJ
Li
Ting
T
Shen
Wen-Jiang
WJ
D000077:Acetabulum / Q000293:injuries; D000328:Adult; D005500:Follow-Up Studies; D050723:Fractures, Bone / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D009999:Ossification, Heterotopic / Q000209:etiology / Q000601:surgery*; D011183:Postoperative Complications / Q000601:surgery*; D016896:Treatment Outcome