The impact of race on the development of severe heterotopic ossification following acetabular fracture surgery.
OBJECTIVE
To determine the association between race on severe heterotopic ossification (HO) following acetabular fracture surgery.


METHODS
Retrospective case control study.


METHODS
Level I university trauma centre.


METHODS
Two hundred and fifty-three patients who were surgically treated for acetabular fractures were retrospectively evaluated. Postoperative radiographs were evaluated for HO by a blinded musculoskeletal radiologist, and classified based on a modified Brooker classification.


RESULTS
Of the 253 patients that met inclusion and exclusion criteria, 175 (69%) were male and 78 (31%) were female. One hundred and fifty-four (61%) patients were Caucasian, and 99 (39%) were African American (AA). Fifty-five (21%) patients developed severe HO. Of those who developed severe HO, 25 were Caucasian (45%), 30 were African American (55%). Forty-one patients (75%) with severe HO were male, and 14 (25%) were female. No statistical differences (p>0.05) were found between groups in terms of age, days to surgery, GCS at presentation, surgical approach, perioperative HO prophylaxis, or AO/OTA fracture classification. The patient population was then stratified by race, gender, and race/gender. AA were more likely than Caucasians to develop severe HO (odds ratio [OR], 2.24; confidence interval [CI], 1.22-4.11). When gender was considered independent of race, no statistical differences (p>0.05) were observed (OR, 1.40; CI, 0.71-2.75). AA males were much more likely to develop severe HO when compared to Caucasian females (OR, 4.4; CI, 1.38-14.06).


CONCLUSIONS
Race is associated with different rates of severe HO formation following acetabular fracture surgery. AA patients are significantly more likely to develop severe HO following acetabular fracture surgery when compared to Caucasian patients.
Department of Orthopaedic Surgery, Medical University of South Carolina, Charleston, SC, United States. Electronic address: sloneh@musc.edu.
Harris S
HS
Slone
Department of Orthopaedic Surgery, Medical University of South Carolina, Charleston, SC, United States.
Zeke J
ZJ
Walton
Department of Orthopaedic Surgery, Emory University, Atlanta, GA, United States.
Charles A
CA
Daly
Department of Radiology, Medical University of South Carolina, Charleston, SC, United States.
Russell W
RW
Chapin
Department of Orthopaedic Surgery, Medical University of South Carolina, Charleston, SC, United States.
William R
WR
Barfield
Department of Orthopaedic Surgery, Medical University of South Carolina, Charleston, SC, United States.
Lee R
LR
Leddy
Department of Orthopaedic Surgery, Medical University of South Carolina, Charleston, SC, United States.
Langdon A
LA
Hartsock
D000077:Acetabulum / Q000293:injuries / Q000473:pathology* / Q000601:surgery; D000328:Adult; D001741:Black or African American; D016022:Case-Control Studies; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000379:methods*; D050723:Fractures, Bone / Q000150:complications / Q000453:epidemiology / Q000473:pathology*; D006801:Humans; D008297:Male; D016017:Odds Ratio; D009999:Ossification, Heterotopic / Q000000981:diagnostic imaging / Q000473:pathology* / Q000517:prevention & control; D011183:Postoperative Complications / Q000453:epidemiology / Q000473:pathology*; D011859:Radiography; D012189:Retrospective Studies; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D044465:White People
Acetabular; Acetabulum; Ectopic; Ectopic ossification; Fracture; Heterotopic; Heterotopic ossification; Ossification