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Lollipop Sign - Ossification at Wire Ends after Osteosynthesis?
Heinz-Lothar Meyer1, Manuel Burggraf1, Christina Polan1
1Department for Trauma, Hand and Reconstruction Surgery, University Hospital Essen Germany, Hufelandstraße 55, Essen, Germany.
Journal of Orthopaedic Case Reports
|September 20, 2019
Summary
Heterotopic ossification (HO) is abnormal bone growth in soft tissue. This study describes a rare "lollipop-like" HO formation around Kirschner wires (K-wires) and titanium elastic nails (TENs) in pediatric patients.
Area of Science:
- Orthopedic Surgery
- Pediatric Orthopedics
- Bone Biology
Background:
- Heterotopic ossification (HO) is the abnormal formation of new bone in soft tissues, commonly around the hip.
- While often asymptomatic, HO can cause pain and functional limitations.
- Current treatments include radiation and NSAIDs, with limited options for specific presentations.
Observation:
- Two pediatric cases of "lollipop-like" HO were observed.
- One case involved a 9-year-old girl post-osteotomy with K-wires.
- The second case involved a 15-year-old boy post-femur fracture fixation with titanium elastic nails (TENs).
Findings:
- HO presented as a distinct "lollipop" shape around the protruding ends of K-wires and TENs.
- The girl was asymptomatic but had limited hip range of motion.
- The boy experienced pain at the ossification site.
Implications:
- This is the first description of "lollipop-like" HO associated with K-wires and TENs.
- Potential causes include repetitive trauma, surgical trauma, or dispersed bone marrow cells.
- The "lollipop sign" may aid in diagnosing this rare HO variant in pediatric patients.
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