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Vol. 37 No. 4, July/August 2000

Heterotopic ossification in rehabilitation patients who have had internal fixation of an acetabular fracture

Steven J. Schafer, MD; Laura Ottaviani Schafer, MD; Jeffrey O. Anglen, MD; Martin Childers, MD

American Sports Medical Institute, Birmingham, AL 35205; Physical Medicine and Rehabilitation, University of Alabama, Birmingham, AL 35294; Orthopedic Trauma Service, Physical Medicine and Rehabilitation, University of Missouri Hospital & Clinics, Columbia, MO 65212

Abstract — High-energy trauma patients often have multiple injuries and are frequently seen by a physiatrist following their acute care. Acetabular fractures are common in this patient population. Following surgical treatment of acetabular fractures, a very high incidence of heterotopic ossification can occur. We describe 94 patients who underwent posterior surgical fixation of an acetabular fracture. Of these, 87 received heterotopic ossification prophylaxis in the form of irradiation or indomethacin; 5 did not receive prophylaxis. Seven of the 45 patients who were initially started on indomethacin had their medication discontinued for various reasons. Of the 12 patients who did not receive adequate prophylaxis, 5 developed disabling heterotopic ossification. We present our experience with this patient population, and we discuss the importance of adequate prophylaxis for heterotopic ossification.

Key words:acetabular, fracture, heterotopic, ossification

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