Abstract
Objective: The aetiology and pathogenesis of heterotopic ossification (HO) are still obscure.
We evaluated the impact of necrotic gluteus minimus muscle (GMM) debridement on the
formation of HO after operative treatment of posterior wall (PW) and associated transverse-posterior
wall acetabular fracture (Tr/PW) fixations utilizing a Kocher–Langenbeck surgical
exposure.
Methods: Thirty-one consecutive patients with displaced PW or associated Tr/PW acetabular
fracture-dislocations were operatively treated by a single surgeon using a Kocher–Langenbeck
surgical exposure. Strict soft tissue technique was observed and self-retaining retractors
were not used. Necrotic GMM was debrided in an attempt to diminish ectopic bone formation.
Results: Twenty-nine patients were available for post-operative clinical and radiographic
evaluations. HO occurred in 12 patients. Significant HO (Brooker class III or IV)
was noted in only three patients (10%). There were no complications associated with
debridement of necrotic GMM.
Conclusions: Necrotic GMM resection diminishes HO formation comparably to other reported series
in which non-steroidal anti-inflammatory medications were used. Resection of the necrotic
GMM from the zone of injury has proved to be an efficient and safe method of preventing
significant HO in patients after operative fixation of PW and associated Tr/PW acetabular
fractures treated through a Kocher–Langenbeck approach.
Keywords
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Article info
Publication history
Accepted:
October 18,
2001
Identification
Copyright
© 2002 Elsevier Science Ltd. Published by Elsevier Inc. All rights reserved.
