|
Year |
2003 |
|---|---|
|
Question Number |
14. |
|
Category |
Musculoskeletal Trauma |
Question
Formation of heterotopic bone in the hip abductor musculature after antegrade intramedullary femoral nailing is most closely associated with
1- ipsilateral tibial fracture
2- the age of the patient
3- timing of fixation
4- reaming
5- wound irrigation
Figures
Answer (click for answer)
Answer: 4
OKU 7: HO may develop in the hip abductor musculature after IM nailing. Local factors such as muscle injury during the approach, reaming debris, and systemic factors may create the environment that promotes HO. HO may limit hip motion, cause pain and limp, and make nail removal more difficult. Incidence has been reported to be as high as 68%.
"The presence of absence of head injury and other factors such as age, sex, severity of injury, level or type of fracture comminution, timing of nailing, or type of IM fixation does not correlate with the development of HO. Wound irrigation with pulse lavage to remove reaming debris has no effect on the severity or frequency"
Injury: Study of 60 anterograde nails in 58 patients. HO incidence rate in reamed group (N= 28) was 35.7%. HO incidence in undreamed group (N=32) was 9.4 %.
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