Early excision of heterotopic bone in the forearm

Five patients undergoing early excision of heterotopic bone in the forearm with radiation therapy and indomethacin were reviewed. Inciting causes of heterotopic ossification included distal biceps tendon repairs, ulna fractures, and a fracture of the radius and ulna. Preoperative forearm rotation arc averaged 17 degrees. Excision was performed at an average of 4 months after injury. Patients were administered 500 to 1,000 cGy of radiation after surgery and received indomethacin for 6 weeks. At an average of 37 months after surgery the forearm rotation arc averaged 136 degrees. All patients had resumed normal activities and had no radiographic recurrence of heterotopic bone or other treatment complications. In the past excision of heterotopic ossification after more than 12 months has been advocated to prevent recurrence. The results of this study suggest that early excision with radiation therapy and indomethacin is a viable option in treating and preventing recurrent heterotopic ossification in the forearm.