Postoperative Single-Fraction Radiation for Prevention of Heterotopic Ossification of the Elbow
- Department of Radiation Oncology, Cleveland Clinic, Cleveland, Ohio (United States)
- Department of Radiology, Cleveland Clinic, Cleveland, Ohio (United States)
- Department of Radiation Oncology, UH Case Medical Center, Cleveland, Ohio (United States)
- Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio (United States)
- Curtis National Hand Center, Baltimore, Maryland (United States)
Purpose: Heterotopic ossification (HO) about the elbow has been described after surgery, trauma, and burns. Even limited deposits can lead to significant functional deficits. Little data exist regarding outcomes of patients treated with radiation therapy (RT) after elbow surgery. We report here the Cleveland Clinic experience with single-fraction radiation following surgery to the elbow. The primary endpoint was the rate of new HO after RT. Secondary endpoints were range of motion, functional compromise, and toxicity. Methods and Materials: From May 1993 to July 2006, 36 patients underwent elbow surgery followed by single-fraction RT. Range of motion data were collected before and during surgery and at last follow-up. Radiographs were reviewed for persistent or new HO. Patient and treatment factors were analyzed for correlation with development of HO or functional compromise. Results: Median follow-up was 8.7 months, median age was 42 years, and 75% of patients were male. Twenty-six (72%) patients had HO prior to surgery. All patients had significant limitations in flexion/extension or pronation/supination at baseline. Thirty-one (86%) patients had prior elbow trauma, and 26 (72%) patients had prior surgery. RT was administered a median of 1 day postoperatively (range, 1-4 days). Thirty-four patients received 700 cGy, and 2 patients received 600 cGy. Three (8%) patients developed new HO after RT. All patients had improvement in range of motion from baseline. No patient or treatment factors were significantly associated with the development of HO or functional compromise. Conclusions: Single-fraction RT after surgery to the elbow is associated with favorable functional and radiographic outcomes.
- OSTI ID:
- 21436123
- Journal Information:
- International Journal of Radiation Oncology, Biology and Physics, Vol. 77, Issue 5; Other Information: DOI: 10.1016/j.ijrobp.2009.06.072; PII: S0360-3016(09)02775-8; Copyright (c) 2010 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; ISSN 0360-3016
- Country of Publication:
- United States
- Language:
- English
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