OBJECTIVETo evaluate the clinical efficacy of surgical treatment using a combined medial and lateral approach combined with an external fixator for the treatment of post-traumatic heterotopic ossification(HO) in patients with stiff elbow joints.

METHODSSurgical release using the combined medial and lateral approach combined with external fixation for the treatment of HO and elbow stiffness in 26 patients from July 2010 to December 2013. The study group included 18 males and 8 females, with an average age 38.7 years (ranged 14 to 60 years). The time from injury to surgery averaged 9.3 (ranged 7 to 18) months. Before and after operation, the elbow range of motion and forearm rotation angle were measured, and the Mayo Elbow Performance Score (MEPS) was evaluated.

RESULTSThe wound of all patients was well healed during the first period, except one patient who had chronic infection at the external fixation pin 3 weeks after operation. Then the external fixator was removed. All 26 patients were followed up, and the during ranged from 24 to 40 months, with an average of 34 months. HO recurrence occurred in 1 patient 8 months after operation. The range of motion, forearm rotation angle, and Mayo Elbow Performance Score of elbow joint in patients was significantly improved compared with that before surgery(<0.05).

CONCLUSIONSSurgical release using the combined medial and lateral approach combined with an external fixator for the treatment of traumatic HO and elbow stiffness can effectively improve elbow function, resulting in a satisfactory effect.