Clinically relevant heterotopic ossification after elbow fracture surgery: A risk factors study

Hong, Choon Chiet; Nashi, Nazrul; Hey, Hwee Weng Dennis; Chee, Yu Han; Murphy, Diarmuid

doi:10.1016/j.otsr.2014.10.021

Cited by 83 publications

(78 citation statements)

References 20 publications

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“…We excluded patients younger than 18 years because of the likelihood that HO development differs between skeletally immature and skeletally mature patients. 5 The patients' electronic medical records and radiographic examinations were reviewed. Demographic data included age, sex, body mass index, American Society of Anesthesiologists class, fracture side (left or right), fracture site, open fracture, underlying diseases (e.g., diabetes, cardiovascular disease, immune disorders), presence of associated dislocation, duration from injury to operation, number of surgeons, type of internal fixation (tension band or plate-screw fixation), operative time, and intraoperative blood loss.…”

Section: Methodsmentioning

confidence: 99%

“…4 Some previous studies have assessed risk factors for symptomatic HO after elbow fracture operations and identified dislocation/no dislocation, 5 compound/closed fracture, 5 fracture type, 2,6 and time from injury to surgery. 1,5,6 To the best of our knowledge, however, no study has focused on the risk factors for asymptomatic HO. In the present study, we investigated the incidence of and risk factors for asymptomatic HO after elbow fracture surgery and compared our results with those of previous similar studies.…”

Section: Introductionmentioning

confidence: 99%

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Incidence of and risk factors for the development of asymptomatic heterotopic ossification after elbow fracture fixation

Zhang

Wang

et al. 2019

J Int Med Res

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Objective This study was performed to investigate the incidence of and risk factors for asymptomatic heterotopic ossification (HO) after open reduction and internal fixation of elbow fractures. Methods This retrospective analysis involved 197 patients with elbow fractures treated operatively from 2014 to 2017 at our institution. Patient-related and clinical variables were recorded. Univariate analysis and multivariate logistic regression were performed to reveal independent risk factors for postoperative HO. In addition, a receiver operating characteristic (ROC) curve was performed to assess the ability of risk factors to predict the development of postoperative HO. Results The overall rate of asymptomatic HO after surgery was 18.78%. The incidence was highest in terrible triad injuries and lowest in capitellum fractures. Independent predictors of asymptomatic HO identified by the multivariate analysis were underlying diseases, fracture dislocation, and a prolonged operative time. The area under the ROC curve for underlying diseases, fracture dislocation, and a prolonged operative time were 0.593, 0.596, and 0.694, respectively. Conclusions The incidence of postoperative asymptomatic HO in patients with elbow fractures is high. Clinicians should employ prophylaxis to avoid HO when treating patients with elbow fractures who have underlying diseases, fracture dislocation, or a prolonged operative time.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Incidence of and risk factors for the development of asymptomatic heterotopic ossification after elbow fracture fixation

Zhang

Wang

et al. 2019

J Int Med Res

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“…Another review of 124 patients with elbow fractures found clinically relevant HO, defined as being Class 2 or greater using the Hastings and Graham classification scheme, in 21% (26/124) of patients(12). …”

Section: Epidemiology and Risk Factorsmentioning

confidence: 99%

Heterotopic Ossification Following Upper Extremity Injury

2017

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Synopsis Heterotopic ossification (HO) presents a substantial barrier to rehabilitation for patients with severe burns or trauma. Although surgical excision is a mainstay of management for this condition, this is unable to address the chronic sequelae of HO including chronic pain, joint contractures, nerve dysfunction, and open wounds. Current therapeutic modalities are aimed towards excision and the prevention of recurrence using NSAIDs or radiation therapy. Research is now focused on identifying alternative strategies to prevent the initial occurrence of HO through NSAIDs and novel inhibitors of the bone morphogenetic protein (BMP) signaling pathway.

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“…The newly formed ectopic bone restricts elbow motion and upper extremity function by a discrete block to motion. Several factors increase the risk of developing HO around the elbow, including central nervous system injury, burns, surgery (i.e., time to surgery and time to mobilization after surgery), and most commonly direct trauma [26][27][28][29][30].…”

Section: Heterotopic Ossificationmentioning

confidence: 99%

The posttraumatic stiff elbow: an update

Mellema

Lindenhovius

Jupiter

2016

Curr Rev Musculoskelet Med

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Posttraumatic elbow stiffness is a disabling condition that remains challenging to treat despite improvement of our understanding of the pathogenesis of posttraumatic contractures and new treatment regimens. This review provides an update and overview of the etiology of posttraumatic elbow stiffness, its classification, evaluation, nonoperative and operative treatment, and postoperative management.

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Clinically relevant heterotopic ossification after elbow fracture surgery: A risk factors study

Abstract: Level IV, retrospective study.

Cited by 83 publications

References 20 publications

Incidence of and risk factors for the development of asymptomatic heterotopic ossification after elbow fracture fixation

Incidence of and risk factors for the development of asymptomatic heterotopic ossification after elbow fracture fixation

Heterotopic Ossification Following Upper Extremity Injury

The posttraumatic stiff elbow: an update

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