[Heterotopic ossification and brain injury]

Abstract

Objectives: The aim of the study was to evaluate the incidence and the risk factors of heterotopic ossifications in patients with severe traumatic brain injury.

Material and methods: This retrospective study was conducted in a sample of 86 patients during a two years period. These patients were receiving care in an acute rehabilitation setting designed for traumatic brain injury patients emerging from coma. The statistical analysis used chi(2) and Fisher tests.

Results, discussion: Forty-nine heterotopic ossifications were observed in 24 patients (incidence 28.57%, 2.04/patient). Most of them were localised at the level of the hip, of the elbow and of the knee. No significant relation was found between heterotopic ossification and sex, age, clinical severity, motor impairment, spasticity or autonomic dysreflexia. On the contrary, associated limb fractures, specially when requiring a surgical treatment, were found to be correlated to a greater incidence of heterotopic ossification.

Conclusion: Some of the risk factors observed in the present study were in accordance with those previously described in the literature. This work shows the difficult place of the initial care of patients with severe traumatic brain injury specially during there stay in intensive care units.