Division of Orthopedic Trauma Surgery, Department of Orthopedic Surgery, NYU Langone Health, NYU Langone Orthopedic Hospital, New York, NY.
Department of Orthopedic Surgery, Stony Brook University School of Medicine, Stony Brook, NY.
J Orthop Trauma. 2018 Aug;32 Suppl 1:S18-S19. doi: 10.1097/BOT.0000000000001197.
Posttraumatic heterotopic ossification (HO) of the hip frequently follows acetabular fracture and hip surgery and can become symptomatic, with significant pain and limited range of motion (ROM). Definitive treatment may require surgical excision, which can result in serious complications if not planned and executed appropriately.
Surgical excision of posttraumatic hip HO requires appropriate indications, preoperative planning, and intraoperative guidance using fluoroscopy to maximize excision of HO and minimize complications. This video presents a case of severe posttraumatic hip HO, indications and technique of surgical excision using fluoroscopic guidance, postoperative protocol, and the patient's clinical follow-up.
Surgical excision along with appropriate postoperative HO prophylaxis and immediate mobilization resulted in significant improvement in hip ROM and return to activities of daily living without complications or recurrence. Intraoperative blood loss can be significant and should be appropriately planned for preoperatively.
Posttraumatic hip HO can cause significantly limited hip ROM and pain with resulting disability. Surgical excision of posttraumatic hip HO in a preserved hip joint can be successful in restoring hip ROM and function. Appropriate postoperative HO prophylaxis can prevent recurrence.
髋关节创伤后异位骨化（HO）常继发于髋臼骨折和髋关节手术，可出现症状，表现为明显疼痛和活动范围（ROM）受限。明确的治疗方法可能需要手术切除，如果计划和执行不当，可能会导致严重的并发症。
髋关节创伤后 HO 的手术切除需要适当的适应证、术前规划和术中透视引导，以最大限度地切除 HO 并减少并发症。本视频介绍了一例严重的髋关节创伤后 HO，展示了使用透视引导进行手术切除的适应证和技术、术后方案以及患者的临床随访情况。
手术切除以及适当的术后 HO 预防和即刻活动可显著改善髋关节 ROM，使患者恢复日常生活活动能力，且无并发症或复发。术中失血可能较多，术前应适当规划。
髋关节创伤后 HO 可导致髋关节 ROM 严重受限和疼痛，导致残疾。在保留髋关节的情况下，对髋关节创伤后 HO 进行手术切除可以成功恢复髋关节 ROM 和功能。适当的术后 HO 预防可防止复发。
