title: Heterotopic ossification resection after open periarticular combat-related elbow fractures.
abstract: A retrospective review was performed to evaluate the outcomes and complications following heterotopic ossification (HO) resection and lysis of adhesion procedures for posttraumatic contracture, after combat-related open elbow fractures. From 2004 to 2011, HO resection was performed on 30 blast-injured elbows at a mean 10 months after injury. Injuries included 8 (27%) Gustilo-Anderson type II fractures, 8 (27%) type III-A, 10 (33%) III-B, and 4 (13%) III-C. Mean preoperative flexion-extension range of motion (ROM) was 36.4°, compared with mean postoperative ROM of 83.6°. Mean gain of motion was 47.2°. Traumatic brain injury, need for flap, and nerve injury did not appear to have a significant effect on preoperative or postoperative ROM. Complications included one fracture, six recurrent contractures, and one nerve injury. The results and complications of HO resection for elbow contracture following high-energy, open injuries from blast trauma are generally comparable to those reported for HO resection following lower energy, closed injuries.
authors: Department of Orthopaedics and Rehabilitation, Walter Reed National Military Medical Center, Bethesda, MD, USA. kevinwilsonmd@gmail.com
authors: Kevin W
authors: KW
authors: Wilson
authors: Jonathan F
authors: JF
authors: Dickens
authors: Reed
authors: R
authors: Heckert
authors: Scott M
authors: SM
authors: Tintle
authors: John J
authors: JJ
authors: Keeling
authors: Romney C
authors: RC
authors: Andersen
authors: Benjamin K
authors: BK
authors: Potter
mesh_terms: D000328:Adult; D004551:Elbow Joint / Q000503:physiopathology; D005597:Fractures, Open / Q000601:surgery*; D006801:Humans; D006810:Humeral Fractures / Q000601:surgery*; D008297:Male; D009999:Ossification, Heterotopic / Q000601:surgery*; D011885:Radius Fractures / Q000601:surgery*; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D000267:Tissue Adhesions / Q000601:surgery; D014458:Ulna Fractures / Q000601:surgery*; D014857:Warfare; D000092464:Elbow Injuries