PREDICTORS OF HETEROTOPIC OSSIFICATION FOLLOWING SURGICALLY TREATED ELBOW TRAUMA
Notice bibliographique
Résumé
Heterotopic ossification (HO) is a common complication following surgically treated elbow trauma. While prophylactic measures have been studied, no interventions have been identified to be effective in the setting of elbow trauma. The primary objective of this study was to determine which patient, injury and surgical characteristics are associated with HO formation after surgically treated elbow trauma. Data for this study were obtained from 158 patients enrolled in a randomized controlled trial assessing the effect of indomethacin as a prophylactic intervention against HO following surgically treated elbow trauma. Injuries included: elbow fracture-dislocations, distal humerus fractures, capitellum/trochlear fractures, radial head fractures, olecranon fractures, trans-olecranon fractures, and monteggia fractures. Binary regression logistical analysis was completed with the presence of heterotopic ossification as the dependent variable to determine patient, injury and surgical characteristics associated with a higher risk of developing HO. Overall, 83 patients (52%) developed HO after surgical treatment of elbow trauma. In terms of patient demographics, dominant arm injury (odds ratio [OR] = 2.05, 95% confidence interval [CI]: 1.05 to 4.02, p = 0.036), BMI ≥ 25 (OR = 2.45, 95% CI: 1.16 to 5.17, p = 0.019), and age (OR = 1.02, 95% CI: 1.00 to 1.04, p = 0.047) all significantly increased the odds of developing HO. In terms of injury diagnoses, elbow fracture-dislocations (OR = 3.46, 95% CI: 1.77 to 6.79, p < 0.001) were more likely to result in HO. Conversely, patients with olecranon fractures (OR = 0.204, 95% CI: 0.07 to 0.58, p = 0.003) had lower odds of developing HO. With respect to surgical intervention, medial collateral ligament (MCL) repair (OR = 5.42, 95% CI: 1.16 to 25.34, p = 0.032), coronoid open reduction and internal fixation (OR = 4.14, 95% CI: 1.87 to 9.19, p < 0.001), and lateral collateral ligament (LCL) repair (OR = 2.79, 95% CI: 1.45 to 5.33, p = 0.002) all significantly increased the odds of developing HO. Patients who underwent medial sided elbow approaches (OR = 4.16, 95% CI: 1.87 to 9.24, p < 0.001) and combined medial and lateral approaches (OR = 6.15, 95% CI: 2.39 to 15.86, p < 0.001) were more likely to develop HO. This study highlights the significant patient, injury and surgical factors that are associated with developing HO following surgical management of elbow trauma. Age, dominant arm injury, BMI ≥ 25, elbow fracture-dislocations, MCL repair, coronoid fixation, LCL repair, medial sided elbow exposures, and combined (medial & lateral) exposures were associated with increased odds of developing HO. Patients with these risk factors should be appropriately counselled regarding their odds of developing this complication. Further HO prophylactic strategies should be developed and studied targeting these high-risk factors in the setting of elbow trauma requiring surgical management.
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Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
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| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
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