Comparison of Development of Heterotopic Ossification in Injured US and UK Armed Services Personnel with Combat-Related Amputations: Preliminary Findings and Hypotheses Regarding Causality
Abstract
Background: Recent reports have documented the rate of heterotopic ossification (HO) formation in the residual limbs of combat-related amputees from the US Armed Forces injured in Operations Iraqi and Enduring Freedom. Final amputation level within the zone of injury and blast as the mechanism of injury were identified as possible risk factors for the occurrence and grade of HO. There has been no previous description of HO in combat-related amputees from the UK service personnel. The purpose of this study was to examine potential differences in the prevalence of HO between UK and US Allied Forces, with particular attention to these risk factors, patient exposures, and any treatment differences between these two groups. Methods: We reviewed the medical records and radiographs of 35 combat- related amputations from the UK and contrasted them with 213 previously reported amputations in US military personnel. We evaluated prevalence and severity of residual limb HO, Injury Severity Score (ISS), the mechanism and zone of injury, type and level of amputation, number of debridements, method of wound irrigation, presence of severe head injury and/or burns injury, use of topical negative pressure therapy and pulse lavage, number of days until wound closure, type of closure, and subsequent infections. All patients had a minimum of 2-month posthospital discharge radiographic follow-up. Comparisons were made using Fisher s exact, one-way analysis of variance, and x2 analysis.
Document Details
- Document Type
- Technical Report
- Publication Date
- Jul 01, 2010
- Accession Number
- ADA629394
Entities
People
- Alan Mistlin
- Benjamin K. Potter
- John Etherington
- Jon C. Clasper
- Joseph R. Hsu
- Kate V. Brown
- Shresth Dharm-datta
Organizations
- United States Army Institute of Surgical Research