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Once ankylosis of the forearm or elbow occurs
3%
51/1714
6 weeks
15%
257/1714
6 months
64%
1089/1714
12 months
250/1714
18 months
52/1714
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Excision of heterotopic bone about the elbow and forearm was classically treated once the bone was mature and no further bone development was occuring (bone scan became negative). However, several studies have shown that earlier removal before this point in time is safe, when done in conjunction with radiation therapy (XRT). The referenced study by McAuliffe et al is a retrospective review of heterotopic ossification (HO) about the elbow followed by 1000 cGY (5 fractions over 1 week) of XRT as early as 3 months post-injury. They were able to achieve an average arc of motion > 100 degrees. The other referenced study by Beingessner et al is a review of HO excision of the forearm. They found that excision and XRT, followed by 6 weeks of indomethacin, led to an increase of forearm motion from an average of 17 degrees to 136 degrees when the excision was done at 4 months post-injury.
2.2
(57)
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