Juengteerapanich Suthat, Udomkiat Pacharapol, Mahaisavariya Banchong
Department of Orthopaedics Surgery, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
J Med Assoc Thai. 2012 Sep;95 Suppl 9:S99-103.
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.
To assess the prevalence and type of heterotopic ossification after closed antegrade femoral nailing.
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.
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).
异位骨化被定义为软组织中的病理性骨形成，通常发生在术后，骨化程度从轻微到大量不等，且常常无症状。异位骨化的病因尚不清楚，但在进行了广泛的骨与软组织解剖的手术后更常发生。闭合性股骨钉固定术后髋外展区域的异位骨化鲜有文献记载。
评估闭合性顺行股骨钉固定术后异位骨化的发生率及类型。
对接受闭合性顺行股骨钉固定术的患者进行回顾性研究。通过查看这组术后至少随访6个月的患者的系列随访X线片来评估异位骨的发生情况。根据Brumback分类法测量并分级异位骨化的大小和范围。
在100例得到完整随访的患者中，有54例（54%）出现异位骨化。异位骨化分级为I级的有16例（16%），II级的有13例（13%），III级的有24例（24%），IV级的有1例（1%）。与股骨干骨折患者相比，转子间骨折患者异位骨化的发生率有显著差异（p值<0.05）。
