抄録
We report the 9-year clinical course of a patient who underwent pedicled posterior interosseous artery adipofascial flap treatment for post-traumatic elbow stiffness caused by proximal radioulnar synostosis resulting from post-traumatic heterotopic ossification (HO). A 66-year-old woman was diagnosed with radial neck fracture and medial collateral ligament injury, and underwent open reduction and internal fixation with plate and ligament suture. Postoperatively, joint contracture of the elbow resulting from HO occurred. We removed the plate from the radial neck, performed posterior release of the lateral collateral ligament, release of the posterior oblique bundle of the medial collateral ligament, proximal radioulnar bone bridge resection, and inserted a pedicled posterior interosseous artery adipofascial flap. During 9 years of follow-up examinations, there was no recurrence of HO or proximal radioulnar synostosis, and the range of motion on physical examination was excellent (extension 0°, flexion 140°, supination 90°, pronation 45°). Post-traumatic HO impedes the progress of treatment for proximal radioulnar bone bridge formation, and the optimal duration from the diagnosis of HO to commencement of this treatment is unclear. We were able to insert the pedicled adipofascial flap without sacrificing the major arteries and prevented the recurrence of bone bridge formation.
