Although uncommon, complete ankylosis of the elbow secondary to heterotopic ossification results in severe disability. The results of surgical management remain unclear.
A single surgeon used a consistent operative technique to treat complete osseous ankylosis of the elbow in 11 limbs in 7 patients after severe burns and in 9 elbows in 8 patients after trauma. The elbows in the burn cohort were more often ankylosed in extension (average, 47° of flexion) compared with those in the trauma cohort (66° of flexion), and they had more skin problems (3 elbows required a free microvascular muscle transfer for coverage) and associated problems of the shoulder, wrist, and hand.
Osseous ankylosis of the elbow is a severely disabling problem, and attempts to regain mobility are both worthwhile and safe. The results are comparable when the ankylosis is caused by burns or trauma despite the greater complexity of osseous ankylosis in the burned arm. Patients and surgeons should be aware of the small risk of recurrent heterotopic ossification and the moderate risk of pain or recurrent contracture after operative release.
Level of evidence: Therapeutic study, Level IV. Copyright remains with the authors and publisher.
Although uncommon, complete ankylosis of the elbow secondary to heterotopic ossification results in severe disability. The results of surgical management remain unclear.
A single surgeon used a consistent operative technique to treat complete osseous ankylosis of the elbow in 11 limbs in 7 patients after severe burns and in 9 elbows in 8 patients after trauma. The elbows in the burn cohort were more often ankylosed in extension (average, 47° of flexion) compared with those in the trauma cohort (66° of flexion), and they had more skin problems (3 elbows required a free microvascular muscle transfer for coverage) and associated problems of the shoulder, wrist, and hand.
Osseous ankylosis of the elbow is a severely disabling problem, and attempts to regain mobility are both worthwhile and safe. The results are comparable when the ankylosis is caused by burns or trauma despite the greater complexity of osseous ankylosis in the burned arm. Patients and surgeons should be aware of the small risk of recurrent heterotopic ossification and the moderate risk of pain or recurrent contracture after operative release.
Level of evidence: Therapeutic study, Level IV. Copyright remains with the authors and publisher.