We report a case of heterotopic ossification in a 60-year-old woman after crush injury with significant skin defects along the right middle, ring, and small fingers, managed with groin flap 38 years previously. Digital heterotopic ossification is extremely rare. As such, case reports of digital heterotopic ossification after trauma and flap reconstruction are few. Over a period of three decades, this patient became symptomatic with palpable bony protrusions of the digits, in addition to pain, swelling, and chronic wounds. The diagnosis was established with plain radiography and computed tomography, which revealed soft tissue ossification adjacent to the distal phalanx of the right ring finger. She underwent surgical excision due to lack of significant improvement after conservative treatment. This case report demonstrates that, although uncommon, heterotopic ossification can occur in a digit after groin flap reconstruction following crush injury of the hand.
