Treatment methods for post-traumatic elbow stiffness caused by heterotopic ossification

Area of Science:

• Orthopedic Surgery
• Regenerative Medicine
• Musculoskeletal Disorders

Background:

• Heterotopic ossification (HO) frequently complicates surgically treated elbow fractures, leading to restricted range of motion and reduced quality of life.
• Current treatment options for HO lack a definitive consensus, necessitating research into more effective interventions.

Purpose of the Study:

• To evaluate the efficacy of contracture release (CR) combined with Botulinum toxin (Botox) injection for treating post-traumatic elbow stiffness due to HO.
• To compare the functional outcomes of CR + Botox with CR alone and CR + radiation therapy (RT).

Main Methods:

• A retrospective review of 59 patients with HO secondary to elbow fracture treated by a single surgeon between 2005 and 2018.
• Patients were categorized into three groups: CR (control), CR + Botox, and CR + RT.
• Pre- and postoperative range of motion (flexion, extension, pronation, supination) were measured.

Main Results:

• Both CR + RT and CR + Botox groups showed significant improvements in the arc of motion post-surgery (P < .01).
• Intraoperative Botox injections with CR led to significant improvements in extension (P < .05).
• The CR-alone group did not demonstrate significant pre- to postoperative motion or extension improvements.

Conclusions:

• Intraoperative Botox injection combined with contracture release is an effective treatment for post-traumatic elbow stiffness caused by HO.
• This combination therapy offers significant functional improvements, particularly in extension, compared to contracture release alone.