A meta-analysis of risk factors for heterotopic ossification after elbow trauma

The objective of this meta-analysis was to determine the incidence and identify risk factors associated with heterotopic ossification after elbow trauma. CNKI, Embase, Medline, and Cochrane central database were searched using a broad range of terms to identify original research, published all through August 2015 and identified potentially studies. Qualified studies had to meet the quality assessment criteria by Newcastle-Ottawa Scale and evaluate the multiple risk factors for heterotopic ossification after elbow trauma. Six studies involving 1636 elbow injury patients and 214 HOs (13.1%) were eligible and included in this meta-analysis. Our meta-analysis identified the significant risk factors for HO about elbow were male gender (OR, 2.03; 95% CI, 1.09-3.81), combined radius/ ulna fractures (OR, 3.46; 95% CI, 1.52-7.88), overall fracture dislocation (OR, 3.13; 95% CI, 1.37-7.16), ulnohumeral fracture dislocations (OR, 4.17; 95% CI, 2.44-7.13), terrible triad (OR, 3.37; 95% CI, 1.93-5.87), floating elbow (OR, 10.23; 95% CI, 3.20-32.68) and delay from injury to surgery (odds per day) (OR, 1.09; 95% CI, 1.04-1.13). The proximal ulna fracture of elbow was likely to be negatively correlated with development of HO about the elbow (OR, 0.31; 95% CI, 0.12-0.78). The other variables including other fracture types, other fracture dislocations, open fracture, infection, head injury and ipsilateral injury were identified not as the risk factors for development of HO. Related prophylaxis strategies should be implemented in patients involved with above-mentioned medical conditions to prevent HO after elbow trauma.