Wilson Kevin W, Dickens Jonathan F, Heckert Reed, Tintle Scott M, Keeling John J, Andersen Romney C, Potter Benjamin K
Department of Orthopaedics and Rehabilitation, Walter Reed National Military Medical Center, Bethesda, MD, USA.
J Surg Orthop Adv. 2013 Spring;22(1):30-5. doi: 10.3113/jsoa.2013.0030.
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.
对与战斗相关的开放性肘部骨折后创伤后挛缩的异位骨化（HO）切除及粘连松解手术的结果和并发症进行了一项回顾性研究。2004年至2011年期间，对30例爆炸伤肘部进行了HO切除，平均受伤后10个月进行手术。损伤包括8例（27%）Gustilo-Anderson II型骨折、8例（27%）III-A型、10例（33%）III-B型和4例（13%）III-C型。术前平均屈伸活动度（ROM）为36.4°，术后平均ROM为83.6°。活动度平均增加47.2°。创伤性脑损伤、皮瓣需求和神经损伤似乎对术前或术后ROM没有显著影响。并发症包括1例骨折、6例复发性挛缩和1例神经损伤。高能爆炸伤后肘部挛缩的HO切除结果和并发症通常与低能闭合伤后HO切除报告的结果相当。
