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. 2017 Aug 4;12(8):e0182303.
doi: 10.1371/journal.pone.0182303. eCollection 2017.

Two new risk factors for heterotopic ossification development after severe burns

Laurent Thefenne  1 , Gratiane de Brier  1 , Thomas Leclerc  2 , Claire Jourdan  3 , Claire Nicolas  4 , Stéphanie Truffaut  5 , Eric Lapeyre  5 , Francois Genet  5   6   7
Affiliations

Two new risk factors for heterotopic ossification development after severe burns

Laurent Thefenne et al. PLoS One. .

Abstract

Objectives: Life after severe burns is conditioned by the remaining sequelae. The pathophysiology and risk factors of Heterotopic Ossification (HO) after burns are still poorly understood. The aim of this study was to determine: 1) the incidence of HO after burns and 2) the risk factors associated with HO development, in a large retrospective study.

Methods: A case-control study of patients admitted to the burns intensive care unit of Percy Hospital, Paris, from the 1st January 2009 to the 31st December 2013 and then admitted to one of three centres specialised in the rehabilitation of patients with burns. Multivariate analysis was carried out to analyse the relationship between HO development and demographic and clinical data.

Results: 805 patients were included. 32 patients (4.0%) developed a total of 74 heterotopic ossifications, that is a little higher incidence than the incidence found in the literature. The epidemiological characteristics of the population studied was similar to the literature. HOs were mainly localized around the elbows, followed by the hips, shoulders and knees. Each case-patient was paired with 3 control-patients. There were significant associations between HO development and the length of stay in the burns intensive care unit, the extent and depth of the burns, the occurrence of pulmonary or cutaneous infections, use of curare and use of an air-fluidized bed.

Conclusion: In addition to recognized risk factors (duration of stay in the intensive care burns unit, extent and depth of burns, pulmonary and cutaneous infections), the use of curare and the use of a fluidized bed (with the duration of use) were significantly associated with HO formation.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Heterotopic ossification around the elbow in patients with burns.
A and B: X-ray images of circumferential HO.
Fig 2
Fig 2. Flow Chart of patients’ files (all patients hospitalized in the ICU for burns between January 1st 2009 and December the 31th 2013).
See this image and copyright information in PMC

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