Appropriate excision time of heterotopic ossiŞcation in elbow caused by trauma

Abstract

Objective: The aim of this study was to investigate the optimal timing for the resection of heterotopicossiŞcation (HO) of the elbow.Methods: We retrospectively reviewed 42 patients who were treated operatively for heterotopic ossiŞcation of the elbow from March 2010 to December 2014 at our institution. The patients were divided intoearly (before 12 months) and late (after 12 months) excision groups. In the early excision group (17patients), the average time from the initial injury to HO excision was 7.4 (3e11) months, and in the lateexcision group (25 patients), the average time was 33.5 (12e240) months. Every patient was evaluatedby range of motion (ROM), the Mayo Elbow Performance Score (MEPS), postoperative complications andHO recurrence.Results: The preoperative mean ROM in the late excision group was greater than that of the early excisiongroup, suggesting that the ROM is expected to increase even without surgery. Both early and late surgeryincreased ROM and MEPS, but early surgery improved ROM and MEPS more than late surgery did(p< .05).Conclusions: Early excision of HO can provide better elbow function, as indicated by ROM and MEPS.Considering that there were no notable differences in postoperative ROM and MEPS, HO recurrence, orpostoperative complications, we concluded that early excision is safe and that the time from an elbowinjury to surgery may be shortened.Level of Evidence: Level III, therapeutic study.© 2017 Turkish Association of Orthopaedics and Traumatology. Publishing services by Elsevier B.V. This isan open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).