Extracorporeal Shockwave Therapy for Painful Chronic Traumatic Heterotopic Ossification after Right Acetabulum Fracture Fixation: A Case Report and Literature Review

Abstract

BACKGROUND: Heterotopic ossification (HO) usually occurs in trauma, such as fractures. To the best of our knowledge, there is a lack of studies about the effects of shockwave on the size of HO in the literature.
 AIM: The aim of this study was to describe the effects of extracorporeal shockwave therapy (ESWT) on the size of HO as well as the lower extremity functions in patients with fracture right acetabulum.
 CASE REPORT: A 36-year-old gentleman had a traffic accident on August 30, 2015, resulted in a fracture of the right acetabulum treated by open reduction and internal fixation on September 2, 2015. The patient has complained of severe right hip pain with limitation of daily activities, especially walking, standing, and sitting, visual analog scale about 7-8/10 with painful and restricted ROM of the right hip. Plain X-ray of the right hip revealed HO at greater trochanter with a long axis length 37.3 mm. ESWT was applied for HO. ESWT was administered 6 times each weekly for 6 weeks. At 6-month follow-up, the size of HO had become slightly smaller with the improvement of pain, and lower extremities functions.
 DISCUSSION: Soft tissues around HO have been regenerated from ischemia for several reasons such as ESWT stimulating angiogenesis and neurogenesis and the size of HO had become slightly smaller by radial shockwave therapy.
 CONCLUSION: ESWT is a novel non-invasive and safe treatment for HO. The effects of ESWT on the size of HO had become slightly smaller with the improvement of lower extremities functions.