Massive intracapsular heterotopic ossification of the anterior ankle joint after talar neck fracture: An unusual case study

Abstract

Heterotopic ossification describes the aberrant formation of ectopic bone in soft tissue. Posttraumatic or acquired heterotopic ossification is a recognized complication of orthopedic trauma, surgery and burns. Heterotopic ossification can be a source of restricted range of motion when located around joints and can also cause pain. In this rare case, a massive intra-articular island of heterotopic ossification developed in the anterior ankle recess subsequent to talar neck fracture two years previously. The patient presented to clinic with a large mass protruding at the anterior ankle and dorsal talar neck, complaining of persistent pain and very limited dorsiflexion at the ankle. Advanced imaging confirmed a large floating mass of heterotopic bone superior to the prior talar neck fracture, within the ankle joint capsule. The patient underwent surgical management with complete excision of the mass which immediately relieved pain and restored motion of the ankle joint. More research is needed to increase our understanding of the pathogenesis, pathology, prevention, treatment and classification of heterotopic ossification in the foot and ankle. Heterotopic ossification should be included in the differential diagnoses for patients with progressing lesions following traumatic incidence, even within intracapsular tissue.

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