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Heterotopic ossification in children with burns: two case reports
1Department of Physical Medicine and Rehabilitation, Children's National Medical Center, Washington, DC 20010-2970.
Insights
Heterotopic ossification, ectopic bone in soft tissue, is a rare complication in pediatric burn patients. This study presents two severe cases, detailing their diagnosis and management.
Area of Science:
- Orthopedic Surgery
- Pediatric Burn Care
- Regenerative Medicine
Background:
- Heterotopic ossification (HO) is the development of bone in extraskeletal soft tissues.
- It is a rare but serious complication following severe burn injuries, particularly in children.
- Understanding HO's pathophysiology is crucial for effective pediatric burn management.
Observation:
- Two pediatric patients with extensive (86% body surface area) burns developed HO.
- Ossification occurred in multiple sites including shoulders, elbows, femur, tibia, fibula, and ribs.
- Symptoms manifested approximately four months post-burn injury.
Findings:
- Detailed clinical, radiological, and laboratory data were collected for both cases.
- Treatment strategies for HO in these pediatric burn patients were documented.
- The study highlights the challenges in diagnosing and managing HO in this population.
Implications:
- This case series provides valuable insights into the incidence and presentation of HO in pediatric burn survivors.
- It underscores the need for vigilant monitoring and early diagnosis of HO post-burn.
- Findings can inform improved treatment protocols for heterotopic ossification in pediatric burn care.
Abstract:
Heterotopic ossification is the formation of ectopic bone in soft tissue, and has been reported as a rare complication in pediatric burn patients. At our hospital, two 86% body surface area burn patients developed heterotopic ossification in the shoulder, elbows, distal femur, proximal tibia, fibula, and ribs approximately four months after the burn injury. These two rare and unusual cases are presented documenting the clinical involvement, radiological studies, laboratory data, as well as treatment of their heterotopic ossification. Discussion will focus on the incidence, diagnosis, pathophysiology, and treatment of heterotopic ossification in burn patients and how this information relates to the specific diagnosis and management of the complication of heterotopic ossification in the burn child.