LOW-DOSE IRRADIATION AND INDOMETHACIN PREVENT HETEROTOPIC OSSIFICATION AFTER ACETABULAR FRACTURE SURGERY

From 1987 to 1991, we treated 53 patients with 54 fractures of the ace tabulum by reconstruction through a posterior or an extended iliofemor al surgical approach. For prophylaxis against heterotopic ossification we used perioperative irradiation and indomethacin. Indomethacin was given as daily doses of 25 mg started within 24 hours of operation and continued for four weeks. Irradiation was by either 1200 cGy in three daily doses or by a single 700 cGy dose on the first postoperative da y. All patients were followed for at least one year postoperatively an d the severity of heterotopic ossification was recorded using the Broo ker classification and correlated with hip mobility. The combination t herapy proved very effective; 44 fractures showed no heterotopic ossif ication and ten showed Brooker class I. The functional results were go od and there were no complications of this therapy. Irradiation with 1 200 cGy did not appear to offer any therapeutic advantage over the 700 cGy dose.