+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Treatment of heterotopic ossification of the elbow following burn injury: recommendations for surgical excision and perioperative prophylaxis using radiation therapy



Treatment of heterotopic ossification of the elbow following burn injury: recommendations for surgical excision and perioperative prophylaxis using radiation therapy



Journal of Shoulder and Elbow Surgery 19(8): 1269-1275



Heterotopic ossification (HO) is reported to occur in 0.1-3.3% of elbows after a severe burn, and can significantly limit elbow motion and upper extremity function. The study included 9 patients (11 elbows) treated by the senior author (TW). The surgical technique consisted of making multiple small surgical approaches to remove heterotopic ossification (without raising cutaneous flaps) and concomitantly releasing the elbow capsule and skin contracture. Perioperative radiation therapy was performed to decrease heterotopic ossification recurrence. Outcome measures included postoperative elbow range of motion and Mayo Elbow Performance Score. The average amount of body surface area burned was 54% (range, 10-86%) and mean time from injury to elbow surgery was 416 days (range, 175-860). All elbows had some degree of direct involvement with the thermal injury. Preoperative arc of motion averaged 39° in flexion/extension and 78° in supination/pronation. Four elbows had complete ankylosis in the flexion/extension plane and 1 had only 5° of motion. At last follow-up, arc of motion in flexion/extension averaged 116° and 139° in supination/pronation, an improvement of 77° and 61°, respectively. One recurrence of HO required re-excision. We recommend this multiple-approach surgical technique for treatment of heterotopic ossification and elbow contracture after burn injury, along with perioperative radiation therapy to decrease recurrence. Our surgical approach and treatment resulted in significant gains in elbow motion and upper extremity function with few complications.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 056674123

Download citation: RISBibTeXText

PMID: 20850996

DOI: 10.1016/j.jse.2010.05.029


Related references

Treatment of heterotopic ossification of the elbow following burn injury: Recommendations for surgical excision and perioperative prophylaxis using radiation therapy. Yearbook of Surgery 2011: 50-52, 2011

Early excision of heterotopic ossification about the elbow followed by radiation therapy. Journal of Bone and Joint Surgery. American Volume 79(5): 749-755, 1997

Radiation Therapy Prophylaxis for Heterotopic Ossification of the Elbow Following Trauma or Recurrent HO. International Journal of Radiation Oncology*biology*physics 84(3): S623-S624, 2012

Radiation therapy for heterotopic ossification prophylaxis afer high-risk elbow surgery. American Journal of Orthopedics 40(8): 400-405, 2012

Radiation therapy for heterotopic ossification prophylaxis acutely after elbow trauma: a prospective randomized study. Journal of Bone and Joint Surgery. American Volume 92(11): 2032-2038, 2010

Radiation Therapy for Heterotopic Ossification Prophylaxis Acutely After Elbow Trauma: A Prospective Randomized Study. Year Book of Hand and Upper Limb Surgery 2011: 148-149, 2011

The time point in surgical excision of heterotopic ossification of post-traumatic stiff elbow: recommendation for early excision followed by early exercise. Journal of Shoulder and Elbow Surgery 24(8): 1165-1171, 2016

Radiation therapy for heterotopic ossification of the elbow. International Journal of Radiation Oncology Biology Physics 54(2 Suppl.): 304-305, 2002

Radiation therapy for prevention of heterotopic ossification about the elbow. Strahlentherapie und Onkologie 185(8): 506-511, 2009

Radiation therapy for the prevention of heterotopic ossification at the elbow. Journal of Bone and Joint Surgery. British Volume 83(3): 332-334, 2001

Radiation therapy for the prevention of heterotopic ossification at the elbow. The Journal of Bone and Joint Surgery. British volume 84-B(2): 305, 2002

Prevention of heterotopic ossification at the elbow following trauma using radiation therapy. Bulletin ) 61(3-4): 151-154, 2004

Radiation therapy for heterotopic ossification prophylaxis. Ugeskrift for Laeger 176(24), 2018

Postsurgical radiation therapy for prophylaxis of heterotopic ossification. New Jersey Medicine 90(9): 672-674, 1993

The surgical treatment of posttraumatic heterotopic ossification about the elbow joint. Hokkaido Journal of Orthopedic & Traumatology 33(2): 31-36, 1990