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Case Reports
. 2016 Sep 16:2016:bcr2015213610.
doi: 10.1136/bcr-2015-213610.

Extra-articular hip impingement due to heterotopic ossification formation at the anterior inferior iliac spine following previous pelvic external fixation

Scott M Sandilands  1 , Brandon L Raudenbush  2 , Dominic S Carreira  3 , Brian J Cross  4
Affiliations
Case Reports

Extra-articular hip impingement due to heterotopic ossification formation at the anterior inferior iliac spine following previous pelvic external fixation

Scott M Sandilands et al. BMJ Case Rep. .

Abstract

Femoroacetabular impingements (FAIs), specifically cam type and pincer type, continue to be accepted as causes of intra-articular hip pathology and sources of hip pain. Reports of other causes of hip impingement including extra-articular causes have surfaced recently. One structure of importance is the anterior inferior iliac spine (AIIS) due to its inconsistent bony morphology and the pull of the rectus femoris muscle putting it at risk for an avulsion fracture. Under certain circumstances, open surgical excision of exostosis formation after an avulsion fracture of the AIIS has been used. The case below represents a clinical scenario in which a medically unstable and multiply injured trauma patient had an external pelvic fixator placed as part of the treatment plan for an unstable pelvic injury. Following this pelvic external fixation treatment, the patient went on to develop clinically significant heterotopic bone formation at the AIIS pin site with extra-articular hip impingement syndrome.

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Figures

Figure 1
Figure 1
Anteroposterior of the pelvis following bilateral sacroiliac screw insertion and external fixator placement 5 days after presentation to the trauma centre.
Figure 2
Figure 2
(A) Anteroposterior radiograph of the pelvis 4 years after pelvic external fixator removal showing the large right anterior inferior iliac spine (AIIS) exostosis. (B) CT reconstruction of the pelvis 4 years after pelvic external fixator removal showing the large right AIIS exostosis.
Figure 3
Figure 3
Intraoperative fluoroscopic view after endoscopic debridement of the AIIS heterotopic bone.
Figure 4
Figure 4
(A) Anteroposterior pelvis radiograph 1 week postoperatively. (B) False profile radiograph of right hip 1 week postoperatively.
See this image and copyright information in PMC

References

    1. Beck M, Leunig M, Parvizi J et al. . Anterior femoroacetabular impingement: part II. Midterm results of surgical treatment. Clin Orthop Relat Res 2004(418):67–73. 10.1097/00003086-200401000-00012 - DOI - PubMed
    1. Ganz R, Parvizi J, Beck M et al. . Femoroacetabular impingement: a cause for osteoarthritis of the hip. Clin Orthop Relat Res 2003(417):112–20. 10.1097/01.blo.0000096804.78689.c2 - DOI - PubMed
    1. Larson CM, Giveans MR. Arthroscopic management of femoroacetabular impingement: early outcomes measures. Arthroscopy 2008;24:540–6. 10.1016/j.arthro.2007.11.007 - DOI - PubMed
    1. Byrd JW, Jones KS. Arthroscopic femoroplasty in the management of cam-type femoroacetabular impingement. Clin Orthop Relat Res 2009;467:739–46. 10.1007/s11999-008-0659-8 - DOI - PMC - PubMed
    1. Larson CM, Giveans MR. Arthroscopic debridement versus refixation of the acetabular labrum associated with femoroacetabular impingement. Arthroscopy 2009;25:369–76. 10.1016/j.arthro.2008.12.014 - DOI - PubMed

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