Resection of heterotopic ossification of the elbow: a comparison of ankylosis and partial restriction.
OBJECTIVE
This study tests the hypothesis that the results of release of elbow stiffness related to heterotopic ossification (HO) are comparable whether there is partial or complete restriction (ankylosis) of flexion and extension.


METHODS
Eighteen patients who had surgical release of complete bony ankylosis between the humerus and ulna were retrospectively compared to 27 matched patients who had surgical release of partial restriction of elbow flexion and extension related to HO. Patients were evaluated a minimum of 10 months after surgery, using the Disabilities of the Arm, Shoulder, and Hand questionnaire and the Broberg and Morrey rating system.


RESULTS
An average of 22 months after surgery (range, 10 to 62 mo), the arc of flexion and extension averaged 95 degrees in the ankylosis cohort and 93 degrees in the partial HO cohort. Forearm rotation averaged 131 degrees versus 134 degrees ; the mean Disabilities of the Arm, Shoulder, and Hand score was 28 versus 30 points; and the mean Broberg and Morrey score was 81 versus 84 points, respectively.


CONCLUSIONS
After controlling for other factors, patients with elbow stiffness related to HO can recover comparable motion after surgical release at short-term follow-up whether they have complete ankylosis or only partial restriction of motion.


METHODS
Therapeutic III.
Brouwer
Kim M
KM
Orthopaedic Hand and Upper Extremity Service, Massachusetts General Hospital, Boston, MA 02114, USA.
Lindenhovius
Anneluuk L C
AL
de Witte
Pieter Bas
PB
Jupiter
Jesse B
JB
Ring
David
D
D000328:Adult; D000844:Ankylosis / Q000175:diagnosis / Q000601:surgery*; D004551:Elbow Joint / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006811:Humerus / Q000601:surgery; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000379:methods*; D009999:Ossification, Heterotopic / Q000175:diagnosis / Q000601:surgery*; D016059:Range of Motion, Articular / Q000502:physiology; D020127:Recovery of Function; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014457:Ulna / Q000601:surgery; D055815:Young Adult