Strauss Jonathan B, Wysocki Robert W, Shah Amar, Chen Sea S, Shah Anand P, Abrams Ross A, Cohen Mark S
Northwestern Memorial Hospital, Chicago, Illinois 60611, USA.
Am J Orthop (Belle Mead NJ). 2011 Aug;40(8):400-5.
Heterotopic ossification (HO) is a common complication of elbow trauma or surgery. HO can impair joint function; when it does, surgical removal is required. Radiotherapy (RT) prevents HO formation in the hip. However, few data exist on the efficacy of RT in preventing HO formation in the elbow. We retrospectively analyzed the outcomes of elbow surgery followed by prophylactic single-fraction RT and use of nonsteroidal anti-inflammatory drugs (NSAIDs). All patients had ectopic bone resected at surgery or significant risk factors for development of ectopic bone. Of the 52 patients who underwent RT after high-risk elbow surgery, 44 had postoperative radiographs of the treated elbow available for evaluation. At a median follow-up of 136 days, 21 patients (48%) had radiographic evidence of HO. In all cases, however, the HO was small and not functionally significant. No complications were attributed to RT use. This retrospective review represents the largest published series of patients who have undergone postoperative RT to prevent HO formation in the elbow. Our findings support the idea that RT, in combination with NSAID use, is safe and efficacious in preventing development of clinically significant HO in the elbow.
异位骨化（HO）是肘部创伤或手术的常见并发症。HO会损害关节功能；当其发生时，需要进行手术切除。放射治疗（RT）可预防髋部HO的形成。然而，关于RT预防肘部HO形成疗效的数据较少。我们回顾性分析了肘部手术后接受预防性单次分割RT并使用非甾体抗炎药（NSAIDs）的结果。所有患者均在手术中切除了异位骨或具有异位骨形成的显著危险因素。在52例高危肘部手术后接受RT的患者中，44例有治疗肘部的术后X线片可供评估。中位随访136天时，21例患者（48%）有HO的影像学证据。然而，在所有病例中，HO均较小且无功能意义。未发现与使用RT相关的并发症。这项回顾性研究是已发表的接受术后RT预防肘部HO形成患者的最大系列研究。我们的研究结果支持这样一种观点，即RT联合NSAIDs使用在预防肘部临床上显著的HO形成方面是安全有效的。
