Stanley Liu, Andrew L Chen, Krishin Shivdasani, Nickolas G Garbis, Dane H Salazar
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引用次数: 0
Abstract
Background: Heterotopic ossification (HO) of the elbow resulting in limited motion is a relatively uncommon condition often caused by burns, trauma, and central nervous system injuries. This retrospective study presents the long-term outcomes of 51 cases of elbow HO treated with surgical excision and regimented postoperative rehabilitation protocol.
Methods: A retrospective case series was conducted on 48 patients (51 elbows) who underwent surgical excision of elbow HO. All procedures were performed in the inpatient setting at an Academic Level I Trauma Center between September 1999 and August 2022 by fellowship-trained upper extremity surgeons. Patient demographics and case characteristics such as age, gender, mechanism of injury, and comorbidities were collected for comparison. Long-term follow-up examinations were elbow flexion-extension arcs, prono-supination arcs, Visual Analog Scale pain scores, and Mayo Elbow Performance Score.
Results: Patients were followed for a minimum of 2 years with an average follow-up of 8 years (range, 2-24 years). The median flexion-extension arc at final follow-up was 110° (95°-130°), which was maintained at 85% of the intraoperative arc achieved. Prono-supination arc at final follow-up was 170° (105°-180°), which was maintained at 97% of intraoperative levels. The median reported Mayo Elbow Performance Score and Visual Analog Scale score were 80 (70-93) and 2 (0-4), respectively. Although it was not statistically significant, patients diagnosed with type II diabetes had the worst flexion-extension arcs at final follow-up and highest complication rates compared to other risk factors.
Conclusion: Surgical excision coupled with HO prophylaxis and a regimented rehabilitation program resulted in a lasting improvement in functional outcomes for patients with elbow dysfunction secondary to HO at long-term follow-up. Overall, patients maintained substantial reductions in pain, improvement in elbow range of motion, and increased overall elbow function.
期刊介绍:
The official publication for eight leading specialty organizations, this authoritative journal is the only publication to focus exclusively on medical, surgical, and physical techniques for treating injury/disease of the upper extremity, including the shoulder girdle, arm, and elbow. Clinically oriented and peer-reviewed, the Journal provides an international forum for the exchange of information on new techniques, instruments, and materials. Journal of Shoulder and Elbow Surgery features vivid photos, professional illustrations, and explicit diagrams that demonstrate surgical approaches and depict implant devices. Topics covered include fractures, dislocations, diseases and injuries of the rotator cuff, imaging techniques, arthritis, arthroscopy, arthroplasty, and rehabilitation.