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Direct Mouse Trauma/Burn Model of Heterotopic Ossification
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Symptomatic Heterotopic Bone Formation after 1,2 ICSRA in Scaphoid Nonunions.

S C Ghijsen1, E Heeg1, T Teunis2

  • 1Department of Plastic, Reconstructive, and Hand Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.

Journal of Wrist Surgery
|May 29, 2024
PubMed
Summary

Heterotopic bone formation occurred in 55% of patients after 1,2 intercompartmental supraretinacular artery (1,2 ICSRA) vascularized bone grafts for scaphoid nonunion. The location suggests the periosteal strip may be a factor, prompting consideration for its size during surgery.

Keywords:
1, 2 ICSRA distal radius graftheterotopic bone formationscaphoid nonunionvascularized bone graft

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Area of Science:

  • Orthopedic Surgery
  • Hand Surgery
  • Bone Grafting Techniques

Background:

  • Heterotopic bone formation is an underreported complication following 1,2 intercompartmental supraretinacular artery (1,2 ICSRA) distal radius vascularized bone grafts (VBGs).
  • Understanding factors influencing heterotopic bone formation is crucial for mitigating this adverse event in scaphoid nonunion treatment.

Purpose of the Study:

  • To identify factors associated with resected heterotopic bone formation after 1,2 ICSRA distal radius VBG for scaphoid nonunion.

Main Methods:

  • Retrospective review of 42 scaphoid nonunions treated with 1,2 ICSRA VBG between 2008-2019.
  • Analysis of patient, fracture, and treatment demographics for correlation with heterotopic bone formation.
  • Assessment of heterotopic bone location and need for resection.

Main Results:

  • Heterotopic bone developed in 55% (23/42) of VBGs, with 12% (5/42) requiring resection.
  • All heterotopic bone was located radially, at the pedicle side.
  • Longer follow-up time was the only variable significantly associated with heterotopic bone development (p=0.028).

Conclusions:

  • The consistent radial location of heterotopic bone suggests a link to the periosteal strip used in the VBG.
  • Surgeons may consider optimizing the size of the periosteal strip to potentially prevent heterotopic ossification after VBGs.