Does Postoperative Radiation Decrease Heterotopic Ossification After the Kocher-Langenbeck Approach for Acetabular Fracture?

• DOI: 10.1007/s11999-015-4609-y
• Publication Date: 2015-10-23T13:54:38Z
• Authors: Jason A. Davis; Brennan Roper; John W. Munz; Timothy S. Achor; Matthew Galpin; Andrew M. Choo; Joshua L. Gary
• Keywords: Acetabular fracture; Buttocks

Controversy regarding heterotopic ossification (HO) prophylaxis exists after Kocher-Langenbeck for treatment of acetabular fracture. Prophylaxis options include antiinflammatory oral medications, single-dose radiation therapy, and débridement gluteus minimus muscle. Prior literature has suggested therapy as the best to prevent HO formation. However, recent reports have emerged radiation-induced sarcoma radiotherapy prophylaxis, which led many surgeons reconsider risks benefits therapy. We set out determine if radiotherapy, in addition standard muscle, affected postoperative formation a approach fracture.(1) After débridement, is associated with decreased risk HO? (2) Does prolong length stay compared patients without radiotherapy?After institutional review board approval, all adult treated fracture by single surgeon between August 2011 October 2014 were identified (n = 60). Débridement muscle caudal superior gluteal bundle was patients. Radiotherapy given dose 700 cGy within 72 hours surgery from until April 2013. Patients subsequently did not receive radiotherapy. indomethacin 1) fewer than 10 weeks followup excluded 12) because several studies suggest that most develops visible point time. Our study group totaled 46 24 22 group. Charts reviewed stay. Attending orthopaedic trauma who blinded patient's graded radiographs according Brooker system, Classes III IV considered clinically important Fisher's exact test used analyze significant differences two groups. Length using t-test.Single-dose (Brooker III-IV) (radiotherapy: one [4%], no radiotherapy: seven [32%], relative risk: 0.131 [95% confidence interval {CI}, 0.018-0.981], p 0.020). Addition result increased 12 ± 7.0 days; 11 7.2 mean difference: 1.0 CI, -3.2 5.2] days, 0.635).Single-dose combination decreases alone No seen. Surgeons chose use concern future may see higher rates fixation.Level III, therapeutic study.