Heterotopic Ossification Resection After Open Periarticular Combat-Related Elbow Fractures


A retrospective review was performed to evaluate the outcomes and complications following heterotopic ossification (HO) resection and lysis of adhesion procedures for posttraumatic contracture, after combatrelated open elbow fractures. From 2004 to 2011, HO resection was performed on 30 blast-injured elbows at a mean 10 months after injury. Injuries included 8 (27%) Gustilo-Anderson type II fractures, 8 (27%) type III-A, 10 (33%) III-B, and 4 (13%) III-C. Mean preoperative flexion–extension range of motion (ROM) was 36.4°, compared with mean postoperative ROM of 83.6°. Mean gain of motion was 47.2°. Traumatic brain injury, need for flap, and nerve injury did not appear to have a significant effect on preoperative or postoperative ROM. Complications included one fracture, six recurrent contractures, and one nerve injury. The results and complications of HO resection for elbow contracture following high-energy, open injuries from blast trauma are generally comparable to those reported for HO resection following lower energy, closed injuries. (Journal of Surgical Orthopaedic Advances 22(1):30–35, 2013)

Kevin W. Wilson, MD; Jonathan F. Dickens, MD; Reed Heckert, MD; Scott M. Tintle, MD;
John J. Keeling, MD; Romney C. Andersen, MD; and Benjamin K. Potter, MD