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

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.