A comparison of contracture severity at acute discharge in patients with and without heterotopic ossification: A burn model system national database study

Model System:

Burn

Reference Type:

Journal article

Accession No.:

J81619

Journal:

Journal of Burn Care And Research (formerly Journal of Burn Care & Rehabilitation)

Year, Volume, Issue, Page(s):

2019 , 40, 3, 349-354

Publication Website:

Abstract:

Study assesses the association between heterotopic ossification (HO) and upper-extremity contracture by comparing goniometric-measured active range of motion (ROM) outcomes of burn patients with and without HO. Data were obtained from the Burn Model System National Database for all patients more than 18 years of age with elbow contracture at acute hospital discharge between 1994 and 2003. Absolute losses in elbow ROM were compared for those with and without radiologic evidence of HO (location undefined) and were further examined by burn-size subgroups using Wilcoxon rank-sum test. Differences in elbow ROM were estimated using regression models, adjusted for demographic and clinical variables. Loss of ROM of the shoulder, wrist, forearm, and hand were also compared. Data from 207 patients yielded 407 instances of elbow flexion or extension contractures. The subjects with HO were found to have greater median absolute loss of elbow flexion among all survivors (median 50 vs 20 degrees), for the 20 to 40 percent total body surface area burn subgroup (70 vs 20 degrees) and for the >40 percent subgroup (50 vs 30 degrees). The adjusted estimate of the mean difference in the absolute loss of elbow flexion between groups was 23.5 degrees. The findings contribute to the understanding of the potential effect of HO on upper-extremity joint ROM, demonstrating a significant association between the presence of HO and elbow flexion contracture severity. Further study is needed to determine the functional implications of HO and develop treatment protocols.

Author(s):