Leni and Peter W. May Departmentof Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Center for Clinical and Outcomes Research, Department of Orthopaedics, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Bone Joint J. 2020 Apr;102-B(4):539-544. doi: 10.1302/0301-620X.102B4.BJJ-2019-1510.R1.
Heterotopic ossification (HO) is a potentially devastating complication of the surgical treatment of a proximal humeral fracture. The literature on the rate and risk factors for the development of HO under these circumstances is lacking. The aim of this study was to determine the incidence and risk factors for the development of HO in these patients.
A retrospective analysis of 170 patients who underwent operative treatment for a proximal humeral fracture between 2005 and 2016, in a single institution, was undertaken. The mean follow-up was 18.2 months (1.5 to 140). The presence of HO was identified on follow-up radiographs.
The incidence of HO was 15% (n = 26). Our multivariate model revealed that male sex (odds ratio (OR) 3.57, 95% confidence interval (CI) 1.30 to 9.80 compared to female) and dislocation as the initial injury (OR 5.01, 95% CI 1.31 to 19.22) were significantly associated with the formation of HO (p < 0.05) while no significant associations were seen for the age of the patient, the characteristics of the injury, or the type of operative treatment.
This retrospective radiological study is the first to investigate the association between the method of surgical treatment for a proximal humeral fracture and the formation of HO postoperatively. We found that male sex and dislocation as the initial injury were risk factors for HO formation, whereas the method of surgical treatment, the age of the patient, and the pattern of the fracture were not predictive of HO formation. While additional studies are needed, these findings can help to identify those at an increased risk for HO formation under these circumstances. Cite this article: 2020;102-B(4):539-544.
异位骨化（HO）是肱骨近端骨折手术治疗的一种潜在破坏性并发症。在这种情况下，关于 HO 发生率和危险因素的文献很少。本研究旨在确定这些患者中 HO 发生的发生率和危险因素。
对 2005 年至 2016 年间在一家医疗机构接受手术治疗的 170 例肱骨近端骨折患者进行回顾性分析。平均随访时间为 18.2 个月（1.5 至 140）。在随访时拍摄 X 线片确定是否存在 HO。
HO 的发生率为 15%（n=26）。我们的多变量模型显示，男性（优势比（OR）3.57，95%置信区间（CI）1.30 至 9.80 与女性相比）和初始损伤为脱位（OR 5.01，95%CI 1.31 至 19.22）与 HO 的形成显著相关（p<0.05），而患者年龄、损伤特征或手术治疗类型与 HO 的形成无显著相关性。
这是首次回顾性放射学研究，探讨了肱骨近端骨折手术治疗方法与术后 HO 形成之间的关系。我们发现，男性和初始损伤为脱位是 HO 形成的危险因素，而手术治疗方法、患者年龄和骨折类型不能预测 HO 的形成。虽然需要进一步的研究，但这些发现可以帮助识别在这种情况下 HO 形成风险增加的患者。
引用本文：2020;102-B(4):539-544.
