David Cooney, CPO, Monalee Luth, CPO, Keith Vinnecour, CPO and I published
an article entitled ‘The Enhancement of Prosthetics through Xeroradiography”
in, the 1985 edition of Orthotics and Prosthetics, vol 39, no 1. In it, we
reported our findings from routinely using xeroradiographs as a diagnostic
tool prior to casting a patient for a prosthesis. In doing so, we discovered
that 41% of the residua of the 92 adult transtibial amputees that we studied
exhibited heterotopic ossification.
To quote our article: ” A comprehensive statistical review of the charts for
the surveyed below knee amputee population was performed to identify the
cause(s) of osteophyte formation. Neither the patient’s age, sex, cause of
amputation, nor tibia length seemed to be a reliable predictor of osteophyte
formation. In fact, three bilateral below knee amputees exhibited osteophytes
on one residual limb and none on the other. The three bilateral below knee
amputees were male. Two of the patients’ amputations were due to dysvascular
causes and were performed at different times. Both amputations of one patient
were performed by the same surgeon. The amputations for the other patient
were performed by different surgeons. The third patient’s amputations were
due to trauma and were performed concurrently.”
Recently, I was surprised to discover ectopic bone formation more than1.5 cm.
long projecting caudad on the inferior ramus of a female transfemoral amputee
which proved to be a challenge to fit. Yes, start looking at radiographs of
your patients and you’ll be amazed.
