Fractures and dislocations about the elbow in the head-injured adult

Of 548 head-injured adults, 16 sustained injuries about the elbow (3%). Sixteen of 18 patients (89%) developed heterotopic ossification (HO). All elbows which had been dislocated developed new bone in the substance or adjacent to the medial or lateral collateral ligaments, or both. Some dislocations also developed significant HO in all planes. Final motion correlated with the amount of HO in the joint. Supracondylar fractures generally developed a moderate amount of anterior or posterior HO, or both. Motion was moderately compromised. Posteriorly located HO developed in olecranon fractures. Range of motion was generally functional. Ectopic bone developed in dislocations of the radial head in the area of the annular ligament, and resulted in mild to moderate loss of motion. Spasticity was not necessarily associated with the development of HO. Two tardy ulnar palsies were noticed and associated with HO in the medial collateral ligament.