title: Heterotopic ossification formation after fracture-dislocations of the elbow.
abstract: BACKGROUND
  Heterotopic ossification (HO) is a serious complication of traumatic elbow injuries, particularly fracture-dislocations. Limited data exist in the literature regarding the risk factors associated with HO formation in these injuries. The purpose of this study was to review the incidence of HO after fracture-dislocation of the elbow and to identify potential risk factors associated with its formation.
  
  
  METHODS
  Twenty-seven patients (28 elbows) were surgically treated for elbow fracture-dislocations during 8 years, with an average follow-up of 14 months. Records were reviewed with attention paid to several factors: demographic data, comorbidities, time interval from injury to surgical intervention, number of closed reductions attempted before surgery, surgical approach, management of the radial head, treatment of the anterior capsular injury, and coronoid fixation.
  
  
  RESULTS
  Of the 28 elbows, 12 (43%) developed HO postoperatively; 9 of 28 elbows underwent multiple attempted closed reductions before definitive surgical stabilization, with HO formation in 7 of the 9 (77%). Time to surgery, age, gender, radial head fixation or replacement, coronoid open reduction and internal fixation, capsular repair, and medical comorbidities were not found to influence HO formation, although the performance of multiple reductions was identified as a risk factor.
  
  
  CONCLUSIONS
  HO developed in 77% of patients with multiple attempted closed reductions. We found a 43% incidence of HO in patients surgically treated for elbow fracture-dislocations. Neither time to surgery after the injury nor demographic or other factors relating to the manner in which associated osseous or soft tissue injuries were managed influenced the formation of HO.
authors.affiliation: Leni and Peter May Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA. Electronic address: dshukla@gmail.com.
authors.forename: Dave R
authors.initials: DR
authors.lastname: Shukla
authors.affiliation: Leni and Peter May Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: Gita
authors.initials: G
authors.lastname: Pillai
authors.affiliation: Leni and Peter May Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: Steven
authors.initials: S
authors.lastname: McAnany
authors.affiliation: Leni and Peter May Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Hausman
authors.affiliation: Leni and Peter May Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: Bradford O
authors.initials: BO
authors.lastname: Parsons
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005593:Fracture Fixation, Internal; D006801:Humans; D015994:Incidence; D057072:Intra-Articular Fractures / Q000150:complications / Q000601:surgery*; D004204:Joint Dislocations / Q000150:complications / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009999:Ossification, Heterotopic / Q000453:epidemiology*; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult; D000092464:Elbow Injuries
keywords: Elbow; coronoid; fracture-dislocation; heterotopic ossification; radial head; terrible triad