Treatment of ectopic ossification about the elbow

The surgical treatment of elbow ectopic ossification associated with elbow stiffness has progressed significantly in the past decade. Although previou s reports describe inconsistent results and high complication rates, numero us recent reports document not only good results, but also lower complicati on rates. The current study outlines the authors' treatment of patients wit h ectopic bone about the elbow. Various modalities have been used for proph ylaxis against elbow ectopic ossification in the patient with elbow trauma. However, despite these prophylaxis efforts, periarticular ossification may form and result in disabling elbow stiffness. If ectopic ossification and stiffness develop, operative intervention may be indicated to restore motio n. It has been long suggested that operative intervention be delayed for at least 1 year, with earlier intervention thought to predispose to recurrenc e. Recent reports, however, have documented good results with earlier inter vention, from 3 to 6 months after injury. The evaluation of posttraumatic e lbow stiffness associated with ectopic ossification is described, followed by a discussion regarding anatomic and functional classifications. Surgery is based on multiple factors including the location of ectopic ossification , the plane(s) of elbow stiffness, and the presence of associated nerve com pression. A limited or extended Kocher approach may be used to release most contractures; however, other approaches may be necessary, Surgical techniq ue is described in detail. Meticulous surgical technique is necessary to av oid complications, including triceps avulsion, recurrent elbow stiffness, a nd hematoma.