Management of elbow ankylosis in a head injured patient with floating elbow injury.

The development of heterotopic ossification around the elbow has been linked to trauma (particularly fractures or dislocations), closed head injury, spinal cord injury, burns of the extremity, genetic traits, adult respiratory distress syndrome, and orthotopic liver transplant. Pain and lack of motion are the most common complaints during the progression of ectopic bone about the joint. Opposite to common credence, fracture healing is not accelerated in patients with traumatic brain injury. Formation of heterotopic bone is not a clinically significant form of healing, therefore healing rates of patients with traumatic brain injury should coincide with those of the general population. Heterotopic bone formation on the medial side of the elbow can cause cubital tunnel compression and ultimately result in ulnar neuropathy. The literature is devoid of any report concerning ectopic bone formation in traumatic brain injury with simultaneous bony trauma to the affected arm. This article presents a case of a patient with a chronic rigidly ankylosed elbow secondary to heterotopic ossification, after suffering a traumatic brain injury, complex periarticular elbow fractures, and an ipsilateral segmental forearm fracture.