Ilahi O A, Strausser D W, Gabel G T
Department of Orthopedic Surgery, Baylor College of Medicine, Houston, Tex., USA.
Orthopedics. 1998 Mar;21(3):265-8. doi: 10.3928/0147-7447-19980301-09.
To evaluate the effect of surgical timing on the formation of heterotopic ossification about the elbow, 71 consecutive patients with elbow trauma requiring operative management were evaluated. Fourteen patients were excluded because they suffered from head injury, burns, or severe open injuries requiring surgery on two or more occasions. Sixteen patients were lost to follow-up, leaving a group of 41 patients. The average age of patients was 35 years. The fractures involved the olecranon in 19, distal humerus in 12, and radial head/neck in 10 patients. Six of these fractures were accompanied by a dislocation. Eleven were open injuries; the remaining 30 were closed. Bone grafting was performed in nine patients. The interval between injury and surgical intervention averaged 57 hours. None (0%) of 17 patients treated within 48 hours developed grade II, III, or IV heterotopic ossification, whereas 8 (33%) of 24 patients treated after 48 hours developed grade II, III, or IV heterotopic ossification. There were no significant differences in demographic or injury parameters between these two groups. These findings suggest that fixation of unstable elbow fractures within 48 hours of injury may reduce the formation of ectopic bone.
为评估手术时机对肘部异位骨化形成的影响，我们对71例连续的需要手术治疗的肘部创伤患者进行了评估。14例患者因头部受伤、烧伤或需要多次手术的严重开放性损伤而被排除。16例患者失访，最终留下41例患者组成的研究组。患者的平均年龄为35岁。骨折部位包括尺骨鹰嘴19例、肱骨远端12例、桡骨头/颈10例。其中6例骨折伴有脱位。11例为开放性损伤；其余30例为闭合性损伤。9例患者进行了骨移植。受伤至手术干预的平均间隔时间为57小时。48小时内接受治疗的17例患者中无一例（0%）发生II级、III级或IV级异位骨化，而48小时后接受治疗的24例患者中有8例（33%）发生II级、III级或IV级异位骨化。这两组患者在人口统计学或损伤参数方面无显著差异。这些研究结果表明，在受伤后48小时内对不稳定的肘部骨折进行固定可能会减少异位骨的形成。
