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Multifactorial refractory heterotopic ossification.

Andrew J L Gear1, Claire Buckley, Fred Kaplan

  • 1Department of Plastic Surgery, University of Minnesota, Minneapolis, MN, USA. agear@mindspring.com

Annals of Plastic Surgery
|May 26, 2004
PubMed
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Aggressive heterotopic ossification (HO) can occur in adults after trauma, leading to recurrent ectopic bone formation resistant to surgery. This case highlights challenges in managing systemic HO in adults, emphasizing aggressive surgical intervention.

Area of Science:

  • Orthopedics
  • Regenerative Medicine
  • Surgical Oncology

Background:

  • Heterotopic ossification (HO) typically follows injury but is usually localized and self-limited.
  • Aggressive, systemic forms of HO are rare, often genetic, and present in infancy.
  • Adult-onset systemic HO is uncommon and poses significant clinical challenges.

Observation:

  • A case of aggressive, systemic HO in an adult following a motor vehicle accident and multiple surgeries is presented.
  • The patient developed a nonhealing wound with recurrent ectopic bone formation.
  • Standard treatments, including skin grafts, were unsuccessful due to rapid recurrence.

Findings:

  • The ectopic bone formation resisted initial surgical treatments and recurred aggressively.

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  • The patient required extensive debridement and delayed rotational flap closure for management.
  • This case underscores the potential for aggressive, adult-onset systemic HO.

    • Implications:

    • Systemic HO in adults requires specialized and aggressive surgical management strategies.
    • Understanding the pathogenesis of adult-onset systemic HO is crucial for developing effective treatments.
    • This case expands the known clinical spectrum of heterotopic ossification.