Incidence of and risk factors for the development of asymptomatic heterotopic ossification after elbow fracture fixation

Objective This study was performed to investigate the incidence of and risk factors for asymptomatic heterotopic ossification (HO) after open reduction and internal fixation of elbow fractures. Methods This retrospective analysis involved 197 patients with elbow fractures treated operatively from 2014 to 2017 at our institution. Patient-related and clinical variables were recorded. Univariate analysis and multivariate logistic regression were performed to reveal independent risk factors for postoperative HO. In addition, a receiver operating characteristic (ROC) curve was performed to assess the ability of risk factors to predict the development of postoperative HO. Results The overall rate of asymptomatic HO after surgery was 18.78%. The incidence was highest in terrible triad injuries and lowest in capitellum fractures. Independent predictors of asymptomatic HO identified by the multivariate analysis were underlying diseases, fracture dislocation, and a prolonged operative time. The area under the ROC curve for underlying diseases, fracture dislocation, and a prolonged operative time were 0.593, 0.596, and 0.694, respectively. Conclusions The incidence of postoperative asymptomatic HO in patients with elbow fractures is high. Clinicians should employ prophylaxis to avoid HO when treating patients with elbow fractures who have underlying diseases, fracture dislocation, or a prolonged operative time.