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Treatment for a femoral shaft bone defect using heterotopic bone formation as autograft

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Abstract

Femoral shaft fractures with large bone loss that are managed with indirect reduction and internal fixation may result in nonunion and remaining bone defects necessitating bone grafting. A 35-year-old male who sustained femoral shaft open fracture with large bone loss was treated using with the minimally invasive plate osteosynthesis technique. Heterotopic bone began to appear 6 weeks postoperatively around the fracture site near bone defect area. This heterotopic bone was used to treat femoral shaft bone defect as autogenous bone graft. The proper timing of heterotopic bone removal to avoid recurrence remains controversial. It has not been reported whether heterotopic bone can be used as autogenous bone graft material to treat bone defect. We describe a simple method to treat large bone defects of the femoral shaft combined with heterotopic bone formation after treatment for femoral shaft fractures with large bone loss using the heterotopic bone as bone graft material. This method will be especially useful for cases that have both long bone defects of the femoral shaft and ectopic bone formation as well as quadriceps entrapment due to ectopic bone.

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References

  1. Kregor PJ, Stannard JA, Zlowodzki M, Cole PA (2004) Treatment of distal femur fractures using the less invasive stabilization system: surgical experience and early clinical results in 103 fractures. J Orthop Trauma 18(8):509–520

    Article  PubMed  Google Scholar 

  2. Ostrum RF, Geel C (1995) Indirect reduction and internal fixation of supracondylar femur fractures without bone graft. J Orthop Trauma 9(4):278–284

    Article  PubMed  CAS  Google Scholar 

  3. Weight M, Collinge C (2004) Early results of the less invasive stabilization system for mechanically unstable fractures of the distal femur (AO/OTA types A2, A3, C2, and C3). J Orthop Trauma 18(8):503–508

    Article  PubMed  Google Scholar 

  4. Garland DE (1988) Clinical observations on fractures and heterotopic ossification in the spinal cord and traumatic brain injured populations. Clin Orthop Relat Res (233): 86–101

  5. Garland DE, O’Hollaren RM (1982) Fractures and dislocations about the elbow in the head-injured adult. Clin Orthop Relat Res (168): 38–41

  6. Potter BK, Forsberg JA, Davis TA, Evans KN, Hawksworth JS, Tadaki D, Brown TS, Crane NJ, Burns TC, O’Brien FP, Elster EA (2010) Heterotopic ossification following combat-related trauma. J Bone Jt Surg Am 92(Suppl 2):74–89

    Article  Google Scholar 

  7. Beingessner DM, Patterson SD, King GJ (2000) Early excision of heterotopic bone in the forearm. J Hand Surg Am 25(3):483–488

    Article  PubMed  CAS  Google Scholar 

  8. Potter BK, Burns TC, Lacap AP, Granville RR, Gajewski DA (2007) Heterotopic ossification following traumatic and combat-related amputations. Prevalence, risk factors, and preliminary results of excision. J Bone Jt Surg Am 89(3):476–486

    Article  Google Scholar 

  9. Tsionos I, Leclercq C, Rochet JM (2004) Heterotopic ossification of the elbow in patients with burns. Results after early excision. J Bone Jt Surg Br 86(3):396–403

    Article  CAS  Google Scholar 

  10. Ali AM, Villafuerte J, Hashmi M, Saleh M (2003) Judet’s quadricepsplasty, surgical technique, and results in limb reconstruction. Clin Orthop Relat Res (415): 214–220

  11. Abrahamsson SO, Ahlgren SA, Dahlstrom JA, Ohlin P, Stigsson L (1984) Ectopic bone after hip replacement. Excision and free fat transplants in four cases. Acta Orthop Scand 55(6):589–592

    Article  PubMed  CAS  Google Scholar 

  12. Mubarak SJ, Patel PN, Upasani VV, Moor MA, Wenger DR (2009) Calcaneonavicular coalition: treatment by excision and fat graft. J Pediatr Orthop 29(5):418–426

    Article  PubMed  Google Scholar 

  13. Barei DP, Taitsman LA, Beingessner D, Dunbar RP, Nork SE (2007) Open diaphyseal long bone fractures: a reduction method using devitalized or extruded osseous fragments. J Orthop Trauma 21(8):574–578

    Article  PubMed  Google Scholar 

  14. Zalavras CG, Patzakis MJ (2003) Open fractures: evaluation and management. J Am Acad Orthop Surg 11(3):212–219

    PubMed  Google Scholar 

  15. Mazurek MT, Pennington SE, Mills WJ (2003) Successful reimplantation of a large segment of femoral shaft in a type IIIA open femur fracture: a case report. J Orthop Trauma 17(4):295–299

    Article  PubMed  Google Scholar 

  16. Wlodarski KH, Reddi AH (1986) Alkaline phosphatase as a marker of osteoinductive cells. Calcif Tissue Int 39(6):382–385

    Article  PubMed  CAS  Google Scholar 

  17. Burd TA, Lowry KJ, Anglen JO (2001) Indomethacin compared with localized irradiation for the prevention of heterotopic ossification following surgical treatment of acetabular fractures. J Bone Jt Surg Am 83(12):1783–1788

    Google Scholar 

  18. Matta JM, Siebenrock KA (1997) Does indomethacin reduce heterotopic bone formation after operations for acetabular fractures? A prospective randomised study. J Bone Jt Surg Br 79(6):959–963

    Article  CAS  Google Scholar 

  19. Moore KD, Goss K, Anglen JO (1998) Indomethacin versus radiation therapy for prophylaxis against heterotopic ossification in acetabular fractures: a randomised, prospective study. J Bone Jt Surg Br 80(2):259–263

    Article  CAS  Google Scholar 

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No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.

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Correspondence to Jin Park.

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The work was performed at the Chonbuk National Univeristy Hospital.

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Park, J., Kim, J.R. & Yang, K.H. Treatment for a femoral shaft bone defect using heterotopic bone formation as autograft. Eur J Orthop Surg Traumatol 22 (Suppl 1), 135–138 (2012). https://doi.org/10.1007/s00590-011-0866-y

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  • DOI: https://doi.org/10.1007/s00590-011-0866-y

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