Heterotopic Ossification Associated with Traumatic Amputation

Warmoth, James E.; Riegel, Bram; McFall, Tracy L.; Pugh, Genevieve; Alvarez, Lizette; Melton, D. Mark; Shelton, Angela D.

doi:10.1097/00008526-199710000-00007

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“…Surgical excision may follow if symptoms persist, usually in a minority of cases [1][2]. A few brief articles described HO in civilians following traumatic amputations [6][7][8], but only one involved blast injuries [6].…”

Section: Introductionmentioning

confidence: 99%

Heterotopic ossification in combat amputees from Afghanistan and Iraq wars: Five case histories and results from a small series of patients

Melcer

Belnap²,

Walker³

et al. 2011

JRRD

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Abstract-Heterotopic ossification (HO) is excess bone growth in soft tissues that frequently occurs in the residual limbs of combat amputees injured in Operation Iraqi Freedom and Operation Enduring Freedom, or Iraq and Afghanistan wars, respectively. HO can interfere with prosthetic use and walking and delay patient rehabilitation. This article describes symptomatic and/or radiographic evidence of HO in a patient series of combat amputees rehabilitating at a military amputee care clinic (27 patients/33 limbs). We conducted a retrospective review of patient records and physician interviews to document evidence of HO symptoms in these limbs (e.g., pain during prosthetic use, skin breakdown). Results showed HO-related symptoms in 10 of the 33 residual limbs. Radiographs were available for 25 of the 33 limbs, and a physician identified at least moderate HO in 15 of the radiographs. However, 5 of the 15 patients who showed at least moderate radiographic HO did not report adverse symptoms. Five individual patient histories described HO onset, symptoms, treatments, and outcomes. These case histories illustrated how HO location relative to pressure-sensitive/pressuretolerant areas of the residual limb may determine whether patients experienced symptoms. These histories revealed the uncommon but novel finding of potential benefits of HO for prosthetic suspension.

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