Heterotopic ossification in the reaming tract of a percutaneous antegrade femoral nail: a case reportReport as inadecuate

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Journal of Medical Case Reports

, 7:90

First Online: 04 April 2013Received: 07 December 2012Accepted: 21 February 2013DOI: 10.1186-1752-1947-7-90

Cite this article as: Botolin, S., Mauffrey, C., Hammerberg, E.M. et al. J Med Case Reports 2013 7: 90. doi:10.1186-1752-1947-7-90


IntroductionHeterotopic ossification is a rare complication of musculoskeletal injuries, characterized by bone growth in soft tissues. Percutaneous antegrade intramedullary nailing represents the ‘gold standard’ for the treatment of femur shaft fractures. Minor bone growth is frequently seen around the proximal end of reamed femoral nails so-called ‘callus caps’, which are asymptomatic and lack a therapeutic implication. The occurrence of excessive, symptomatic heterotopic ossification around the entry site of an antegrade femoral nail is rarely described in the literature.

Case presentationWe present the case of a 28-year-old Caucasian woman who developed extensive heterotopic ossification around the reaming seeds of a reamed femoral nail. She developed severe pain and significantly impaired range of motion of the hip joint, requiring revision surgery for heterotopic ossification resection and adjunctive local irradiation. She recovered full function of the hip and remained asymptomatic at her two-year follow-up appointment.

ConclusionsSevere heterotopic ossification represents a rare but potentially detrimental complication after percutaneous femoral nailing of femur shaft fractures. Diligent care during the reaming procedure, including placement of a trocar to protect from osteogenic seeding of the soft tissues, may help decrease the risk of developing heterotopic ossification after reamed antegrade femoral nailing.

KeywordsHeterotopic ossification Femoral nailing Femur fracture Complication Electronic supplementary materialThe online version of this article doi:10.1186-1752-1947-7-90 contains supplementary material, which is available to authorized users.

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Author: Sergiu Botolin - Cyril Mauffrey - E Mark Hammerberg - David J Hak - Philip F Stahel

Source: https://link.springer.com/

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