Zusammenfassung
Schwere Schädel-Hirn-Traumata, Rückenmarksverletzungen oder isolierte Gelenkverletzungen
können mit heterotopen Ossifikationen einhergehen. Nach Brandverletzungen stellen
periartikuläre Knochenneubildungen eine seltene, schwerwiegende Komplikation dar,
deren Pathogenese noch unklar ist. Wir stellen den Verlauf eines Patienten vor, bei
dem es nach Brandverletzungen, betreffend 60 % der Körperoberfläche; zum Auftreten
von heterotopen Ossifikationen gekommen war. Erschwert wurde der Gesamtverlauf durch
ein Inhalationstrauma.
Abstract
Heterotopic ossifications in periarticular tissue can appear after severe head injury,
spine trauma or local joint trauma. Following extensive burns, heterotopic ossifications
are a rare, severe complication with an unclear pathogenesis. We report one case with
this kind of complication in a 50-year old male patient who sustained full and partial
thickness burn injuries over 60 % of the body. The thermal injury was accompanied
by a severe inhalation injury.
Schlüsselwörter
heterotope Ossifikation - Verbrennungsverletzung - Ellenbogengelenk
Key words
heterotopic ossifications - burn injury - elbow joint
Literatur
1
Crawford C M, Varghese G, Mani M M, Neff J R.
Heterotopic ossification: are range of motion exercises contraindicated?.
J Burn Care Rehabil.
1986;
7
323-327
2
Elledge E S, Smith A A, McManus W F, Pruitt Jr B A.
Heterotopic bone formation in burned patients.
J Trauma.
1988;
28
684-687
3
Evans E B.
Orthopaedic measures in the treatment of severe burns.
J Bone Joint Surg [Am].
1966;
48
643-669
4
Evans E B.
Heterotopic bone formation in thermal burns.
Clin Orthop Relat Res.
1991;
263
94-101
5
Evans E B, Smith J R.
Bone and joint changes following burns; a roentgenographic study; preliminary report.
J Bone Joint Surg [Am].
1959;
41
785-799
6
Garland D E.
A clinical perspective on common forms of acquired heterotopic ossification.
Clin Orthop Relat Res.
1991;
263
13-29
7
Garland D E, Hanscom D A, Keenan M A, Smith C, Moore T.
Resection of heterotopic ossification in the adult with head trauma.
J Bone Joint Surg [Am].
1985;
67
1261-1269
8
Gaur A, Sinclair M, Caruso E, Peretti G, Zaleske D.
Heterotopic ossification around the elbow following burns in children: results after
excision.
J Bone Joint Surg [Am].
2003;
85
1538-1543
9
Jay M S, Saphyakhajon P, Scott R, Linder C W, Grossman B J.
Bone and joint changes following burn injury.
Clin Pediatr (Phila).
1981;
20
734-736
10
Kluger G, Kochs A, Holthausen H.
Heterotopic ossification in childhood and adolescence.
J Child Neurol.
2000;
15
406-413
11
Koch B M, Wu C M, Randolph J, Eng G D.
Heterotopic ossification in children with burns: two case reports.
Arch Phys Med Rehabil.
1992;
73
1104-1106
12
Kolar J, Babicky A, Bibr B, Vrabec R.
Systemic effects of burns on bone mineral metabolism.
Acta Chir Plast.
1971;
13
133-140
13
McCarthy E F, Sundaram M.
Heterotopic ossification: a review.
Skeletal Radiol.
2005;
34
609-619
14
Munster A M, Bruck H M, Johns L A, Von Prince K, Kirkman E M, Remig R L.
Heterotopic calcification following burns: a prospective study.
J Trauma.
1972;
12
1071-1074
15
Pape H C, Lehmann U, van Griensven M, Gansslen A, von Glinski S, Krettek C.
Heterotopic ossifications in patients after severe blunt trauma with and without head
trauma: incidence and patterns of distribution.
J Orthop Trauma.
2001;
15
229-237
16
Peterson S L, Mani M M, Crawford C M, Neff J R, Hiebert J M.
Postburn heterotopic ossification: insights for management decision making.
J Trauma.
1989;
29
365-369
17
Pruitt Jr B A.
Complications of thermal injury.
Clin Plast Surg.
1974;
1
667-691
18
Puzas J E, Miller M D, Rosier R N.
Pathologic bone formation.
Clin Orthop Relat Res.
1989;
245
269-281
19
Shafritz A B, Kaplan F S.
Differential expression of bone and cartilage related genes in fibrodysplasia ossificans
progressiva, myositis ossificans traumatica, and osteogenic sarcoma.
Clin Orthop Relat Res.
1998;
346
46-52
20
Summerfield S L, DiGiovanni C, Weiss A P.
Heterotopic ossification of the elbow.
J Shoulder Elbow Surg.
1997;
6
321-332
21
Tsionos I, Leclercq C, Rochet J M.
Heterotopic ossification of the elbow in patients with burns. Results after early
excision.
J Bone Joint Surg [Br].
2004;
86
396-403
22
Viola R W, Hanel D P.
Early “simple” release of posttraumatic elbow contracture associated with heterotopic
ossification.
J Hand Surg [Am].
1999;
24
370-380
23
Wahl B, Grasshoff H, Meinecke I, Neumann H W.
Klinische und radiologische Ergebnisse der operativen Entfernung von periartikulären
Ossifikationen nach Hüftendoprothese.
Unfallchirurg.
2002;
105
523-526
Dr. med. Frank Siemers
Plastische, Handchirurgie, Intensiveinheit für Schwerbrandverletzte Universitätsklinikum Schleswig-Holstein, Campus Lübeck
Ratzeburger Allee 160
23538 Lübeck
Email: f.siemers@gmx.de