title: Prophylaxis against heterotopic ossification after elbow and acetabular fractures - Do we really need it.
abstract: OBJECTIVE
  To compare the efficacy and safety of prophylactic modalities for heterotopic ossification prevention after elbow and acetabular surgeries.
  
  
  METHODS
  The retrospective chart review was conducted at the Aga Khan University Hospital and comprised record of patients who underwent open reduction and internal fixation for elbow and acetabular fractures between 2010 and 2013. Data was classified into three groups: Group A patients had received single dose of radiotherapy; Group B patients had received indomethacin, and Group C patients had not received any prophylaxis. Outcome variables included time-to-fracture healing, heterotopic ossification, non-union and wound infection.
  
  
  RESULTS
  Of the 104patients 70(67.3%) had elbow fractures and 34(32.7%) had acetabular fractures. Out of the 70patients with elbow fractures, 28(27%) were in Group A, 24(23%) in Group B, and 18(17%) in Group C. In Group A, 4(22%) patients had wound infection compared to 1(5.5%) patient in Group C (p=0.131). One (4%) patient in Group B and 1(5.5%) in Group C developed heterotopic ossification (p=0.486). Non-union occurred in 1(4%) patient in Group B and 1(5.5%) in Group C. Out of the 34 patients with acetabular fractures, 11(32.3%) were in Group A, 10(29.4%) in Group B, and 13(38.2%) in Group C. In Group A, 2(18.2%) patients developed wound infection. Only 1(7.6%) patient in Group C developed heterotopic ossification.
  
  
  CONCLUSIONS
  No role of radiotherapy or indomethacin was detected in the prevention of heterotopic ossification.
authors.affiliation: Department of Orthopedic, Aga Khan University Hospital, Karachi.
authors.forename: Rizwan Haroon
authors.initials: RH
authors.lastname: Rashid
authors.affiliation: Combined Military Hosptial (CMH), Multan.
authors.forename: Irfan
authors.initials: I
authors.lastname: Qadir
authors.affiliation: Department of Orthopedic, Aga Khan University Hospital, Karachi.
authors.forename: Waseem
authors.initials: W
authors.lastname: Ahmed
authors.affiliation: Department of Orthopedic, Aga Khan University Hospital, Karachi.
authors.forename: Masood
authors.initials: M
authors.lastname: Umer
keywords: Heterotopic ossification, Elbow, Acetabulum, Fracture, Pakistan.