Functional outcome following surgical excision of heterotopic ossification in patients with traumatic brain injury

Increased osteogenesis, both in fracture healing and heterotopically, occurs in a significant percentage of patients with traumatic brain injury. Periarticular heterotopic ossification, especially in the hip and elbow joint, can cause functional loss of motion in patients with traumatic brain injury and interfere with activities of daily living. Seventeen patients with traumatic brain injury had periarticular heterotopic ossification resected in 20 joints (13 hips and seven elbows). Each joint was ankylosed prior to surgical resection (Brooker IV). In the immediate postoperative period, the average arc of motion was 85 degrees in the hips and 65 degrees in the elbows. At the final follow-up observation (average, 23 months), 17 of the 20 heterotopic ossification resected joints had maintained functional range of motion. Three joints in two patients reankylosed. Two additional patients had significant complications. In summary, surgical excision of periarticular heterotopic ossification in patients with traumatic brain injury can give satisfactory results, provided appropriate preoperative selection is done.