Heterotopic Ossifications in Patients After Severe Blunt Trauma With and Without Head Trauma: Incidence and Patterns of Distribution

Pape, Hans-Christian; Lehmann, U.; Griensven, Martijn van; Gänsslen, Axel; Gliński, S; Krettek, Christian

doi:10.1097/00005131-200105000-00001

Cited by 66 publications

(61 citation statements)

References 55 publications

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“…These patients had long intensive care stays in common and approximately 1 . 3 were reported to suffer from a decreased ROM in initially uninjured joints. This was in part due to heterotopic ossification [51]. Moreover, the importance of injuries below the knee for long-term outcome was confirmed in previous studies [36,70,78].…”

Section: Effects Of Clinical and Experimental Research On In-hospitalsupporting

confidence: 64%

“…In patients with a very high Injury Severity Score, it appears systemic interactions aside from the initial injury can heavily affect subsequent function [23]. A 5-year followup of 50 MOF survivors revealed considerable deficits in the ROM of the ankle, knee, hip, and elbow [51]. These patients had long intensive care stays in common and approximately 1 . 3 were reported to suffer from a decreased ROM in initially uninjured joints.…”

Section: Effects Of Clinical and Experimental Research On In-hospitalmentioning

confidence: 99%

See 1 more Smart Citation

Trauma Care in Germany: An Inclusive System

Sturm

Pape²,

Dienstknecht³

2013

Clinical Orthopaedics &Amp; Related Research

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Section: Effects Of Clinical and Experimental Research On In-hospitalsupporting

confidence: 64%

Section: Effects Of Clinical and Experimental Research On In-hospitalmentioning

confidence: 99%

Trauma Care in Germany: An Inclusive System

Sturm

Pape²,

Dienstknecht³

2013

Clinical Orthopaedics &Amp; Related Research

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“…Interestingly, prolonged mechanical ventilation has been demonstrated as a risk factor for HO in other studies assessing hips without a fracture of the acetabulum, around uninjured joints, or around the hip after femoral nailing [17,23,30]. Pape et al [23] demonstrated an increased frequency of HO around uninjured joints in polytraumatized patients without head trauma compared with patients with head trauma suggesting that other pathways are involved. This is consistent with our findings in that we did not find a correlation between head AIS and HO.…”

Section: Discussionmentioning

confidence: 98%

“…Injury Severity Score (ISS) has also been demonstrated as a risk factor for ectopic bone around the hip after femoral nailing as well as around the knee after knee dislocation [17,20]. Need for prolonged mechanical ventilation has been demonstrated as a risk factor for the development of ectopic bone in uninjured joints of polytraumatized patients as well as around the hip after femoral nailing [17,23,30], but to our knowledge, not specifically after operatively treated acetabular fractures.…”

Section: Introductionmentioning

confidence: 99%

Risk Factors for the Development of Heterotopic Ossification After Acetabular Fracture Fixation

Firoozabadi

O'Mara

Swenson

et al. 2014

Clinical Orthopaedics &Amp; Related Research

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Background Heterotopic ossification (HO) is a common complication of the operative treatment of acetabular fractures. Although the surgical approach has been shown to correlate with the development of ectopic bone, specific risk factors have not been elucidated. Questions/purposes The purposes of this study were to determine specific risk factors associated with the development of severe HO and the frequency with which patients develop severe HO after acetabular fracture fixation through an isolated Kocher-Langenbeck approach. Methods Using an institutional orthopaedic trauma database at a regional Level I trauma center, patients undergoing open treatment of acetabular fractures during the study period (January 2000 to January 2010) were identified. A review of medical records and imaging studies was performed on 508 patients who were treated by the senior author (MR) through an isolated Kocher-Langenbeck approach. During the study period, the senior author used indomethacin for HO prophylaxis in patients who had ipsilateral femur fracture treated with antegrade reamed medullary nailing or severe local soft tissue injury; 49 (10%) of the patients he treated with the Kocher-Langenbeck approach received prophylaxis, and they were excluded from this study, leaving a total of 459 patients who met inclusion criteria. Of those, 147 (29%) were lost to followup or did not have radiographs both before and at a minimum of 6 weeks (median, 1 week; range, 0-3 weeks), leaving 312 (61% of the patients treated with the Kocher-Langenbeck approach during this time) available for this analysis. Demographic data as well as information related to cause of injury, associated periacetabular findings, other system injuries, and treatment were gathered. Final followup radiographs were assessed for the presence of ectopic bone by two of the authors (TJO, AS) using the modified Brooker classification. Logistic regression was performed to identify possible predictors of development of severe ectopic bone. Results The only predictor we identified for the development of severe HO was the need for prolonged mechanical ventilation (odds ratio, 7

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“…3 HO is known to occur following a variety of situations such as severe muscular injury, following total hip and knee replacement surgery, severe head and spinal cord injury, prolonged assisted ventilation, prolonged immobilisation, ARDS, burns and pancreatitis. 1, [4][5][6][7] The pathogenesis of HO is unknown. An imbalance between certain forms of bone morphogenetic protein and their antagonists has been suggested as likely precipitating factor in development of HO.…”

Section: Introductionmentioning

confidence: 99%