Shukla Dave R, Pillai Gita, McAnany Steven, Hausman Michael, Parsons Bradford O
Leni and Peter May Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Leni and Peter May Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
J Shoulder Elbow Surg. 2015 Mar;24(3):333-8. doi: 10.1016/j.jse.2014.11.037. Epub 2015 Jan 16.
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.
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.
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.
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.
异位骨化（HO）是创伤性肘部损伤的严重并发症，尤其是骨折脱位。关于这些损伤中与HO形成相关的危险因素，文献中的数据有限。本研究的目的是回顾肘部骨折脱位后HO的发生率，并确定与其形成相关的潜在危险因素。
27例患者（28个肘部）在8年期间接受了肘部骨折脱位的手术治疗，平均随访14个月。对记录进行了回顾，关注以下几个因素：人口统计学数据、合并症、受伤至手术干预的时间间隔、手术前尝试闭合复位的次数、手术入路、桡骨头的处理、前关节囊损伤的治疗以及冠突固定。
28个肘部中，12个（43%）术后发生HO；28个肘部中有9个在最终手术稳定前进行了多次闭合复位尝试，其中9个中的7个（77%）形成了HO。未发现手术时间、年龄、性别、桡骨头固定或置换、冠突切开复位内固定、关节囊修复以及内科合并症对HO形成有影响，尽管多次复位被确定为一个危险因素。
多次尝试闭合复位的患者中77%发生了HO。我们发现接受肘部骨折脱位手术治疗的患者中HO发生率为43%。受伤后的手术时间以及与相关骨或软组织损伤处理方式有关的人口统计学或其他因素均未影响HO的形成。
