Acellular Dermal Matrix to Prevent Recurrent Radioulnar Heterotopic Ossification | Dr. Daniel Gould

Dr. Daniel Gould co-authored this case report published in Plastic and Reconstructive Surgery Global Open, examining the use of human acellular dermal matrix (ADM) to help prevent recurrence of heterotopic ossification between the radius and ulna.

Radioulnar heterotopic ossification is a rare condition in which abnormal bone forms between the two bones of the forearm. This can restrict rotation of the forearm and wrist, affecting everyday movements that depend on pronation and supination.

Treatment typically involves surgically removing the abnormal bone. However, recurrence can present a significant challenge, leading surgeons to explore techniques that create a physical barrier between the radius and ulna following removal.

Dr. Gould and his co-authors described a technique using human acellular dermal matrix placed between the two bones after resection. The ADM was formed into a barrier designed to prevent the radius and ulna from reconnecting through recurrent bone formation. 

The technique was used in two female patients. At an average follow-up of 36 months, both demonstrated significant improvement in forearm rotation, with no postoperative complications and no recurrence of heterotopic ossification. 

The report highlights ADM as a potential biologic option for preventing recurrence while avoiding the donor-site morbidity associated with harvesting a patient's own tissue. The findings provide an early foundation for further investigation of this technique in reconstructive hand and upper extremity surgery.