This article is more than 5 years old. Information may no longer be current.
Prophylactic radiation therapy questioned for heterotopic ossification after elbow trauma
Hamid N. JBJS (Am). 2010;92:2032-2038
Click Here to Manage Email Alerts
This prospective, level 1 evidence, randomized multi-centered study aimed to investigate the safety and efficacy of a single prophylactic dose of radiation therapy following elbow trauma, if it could reduce the need for surgical excision of heterotopic ossification and perhaps improve clinical results. However, it was terminated prior to completion due to an unacceptably high number of adverse events reported in the treatment group.
The investigators randomized 48 patients with an intra-articular distal humeral fracture or a fracture-dislocation of the elbow with proximal radial and/or ulnar fractures were enrolled to receive either single-fraction radiation therapy of 700 cGy within 72 hours of surgical treatment or nothing for the control group.
When the rate of complications was investigated, a significant difference was detected in the frequency of nonunion between the groups, the investigators reported. The nonunion rate was 38% of 21 patients in the treatment group, which was significantly different from the rate of 4% of 24 patients in the control group.
They concluded that postoperative single-fraction radiation therapy, when used acutely after elbow trauma for prophylaxis against heterotopic ossification, may play a role in increasing the rate of nonunion at the site of the fracture or an olecranon osteotomy. Also, they noted that the clinical efficacy of radiation therapy could not be determined on the basis of the sample size.