Extensive Post-Traumatic Heterotopic Ossification with Multi-joint Involvement: A Case Report

Heterotopic ossification (HO) is a recognized complication following severe trauma, but simultaneous involvement of multiple joints is rare. This case highlights the diagnostic and management challenges posed by extensive HO and proposes potential screening and prophylaxis strategies applicable to polytrauma patients.

A male in his mid-twenties sustained severe polytrauma from a motor vehicle accident, resulting in multiple fractures, requiring several surgeries and prolonged mechanical ventilation. After initial improvement in joint mobility in the intensive care unit, he developed progressive joint stiffness and pain across multiple limbs. HO was confirmed by radiographic and ultrasound imaging. Treatment included non-steroidal anti-inflammatory drugs (NSAIDs) and months of intensive multidisciplinary rehabilitation, which slowly improved function but left significant mobility deficits. The patient declined surgical intervention for mobility enhancement due to perceived adequate functional capability. At 11 months, the patient achieved near-normal ambulation without assistive devices. However, significant knee mobility deficits persisted bilaterally.

Extensive multi-joint HO can occur in polytrauma patients and poses significant diagnostic and therapeutic challenges. Early detection with ultrasound and early prophylaxis with NSAIDs may help reduce long-term morbidity.