POSTTRAUMATIC HETEROTOPIC OSSIFICATION ABOUT THE ELBOW

To evaluate the effect of surgical timing on the formation of heteroto pic ossification about the elbow, 71 consecutive patients with elbow t rauma requiring operative management were evaluated. Fourteen patients were excluded because they suffered from head injury, burns, or sever e open injuries requiring surgery on two or more occasions. Sixteen pa tients were lost to followup, leaving a group of 41 patients. The aver age age of patients was 35 years. The fractures involved the olecranon in 19, distal humerus in 12, and radial head/neck in 10 patients. Six of these fractures were accompanied by a dislocation. Eleven were ope n injuries; the remaining 30 were closed. Bone grafting was performed in nine patients. The interval between injury and surgical interventio n averaged 57 hours. None (0%) of 17 patients treated within 48 hours developed grade II, III, or IV heterotopic ossification, whereas 8 (33 %) of 24 patients treated after 48 hours developed grade II, III, or I V heterotopic ossification. There were no significant differences in d emographic or injury parameters between these two groups. These findin gs suggest that fixation of unstable elbow fractures within 48 hours o f injury may reduce the formation of ectopic bone.