Heterotopic ossification in burns: our experience and literature reviews

Heterotopic ossification (HO) is an uncommon, but high profile complication of burns. In this paper, a retrospective study was undertaken to evaluate our treatment and results of HO. Relevant literature was also reviewed to search for new advances in prevention and management for patients with HO after burns.

A retrospective study was undertaken in Chang Gung Memorial Hospital, Linkou. We collected 12 patients who suffered from HO after burn and received operation in our hospital between June 2000 and September 2007. The data was expressed as mean.

Patients' gender distribution was 10 males and 2 females. The mean age was 43 years old (range, 30-59). Causes of burn were flame burn (75%), scald burn (8%), contact burn (8%), and high-voltage electrical burn (8%). Mean TBSA was 39% (range, 8-90%). Nine of 12 patients (75%) were admitted to intensive care unit (ICU) and 6 (50%) received mechanical ventilator support. The mean ICU stay was 82 days (range, 26-240 days). The elbow was the most commonly affected joint (92%). The outcome of surgery was acceptable in all elbows at the time of surgery. The mean ROMs before surgery were 31 degrees (range, 0-75 degrees). The mean ROMs after surgery were 99 degrees (range, 70-115 degrees); mean gain was 68 degrees (range, 35-115 degrees). One (8%) patients had recurrent HO after operation. The mean outpatient department follow-up time was 14.6 months (range, 1-40 months). The incidence of HO in our burn center is 0.15%.

Although HO after burn is uncommon, physicians should keep the complication in mind. When burn patients complain decreased ROM or "locking sign" in their joints, X-ray examination is indicated to rule out HO. Surgery is the treatment of choice when the diagnosis of HO is confirmed.