我们对烧伤患者的回顾性研究提出了异位骨化的三步治疗方法:切除手术,早期康复,和镇痛。我们纳入了1979年1月1日至2015年9月30日期间入院治疗烧伤后异位骨化的患者。烧伤时的平均年龄为43.3岁。男性占发生骨瘤的烧伤患者的大多数(70.8%)。平均烧伤皮肤总面积为38.4%。对于所有烧伤皮肤面积小于19%的患者,均未发现骨瘤证明手术合理。在94.3%的病例中,烧伤区与骨瘤的发展有关。平均而言,手术发生在烧伤后10.8个月。在37.1%的患者中,截骨术伴随着挛缩的手术治疗。大部分骨瘤是在肘部发现的(30),其次是肩膀(3),最后是膝盖(2)。手术后D0开始康复,除非使用皮瓣或薄皮肤移植物。关于镇痛,术后即刻对阿片类药物进行了系统处方.肘部屈曲运动范围平均改善84.1°。在术后期间,我们在两个独立的患者中发现2例骨瘤复发和1例肘部血肿复发。术后无感染或神经系统后遗症。我们的回顾性法国研究证实了国际文献中的结果。三步治疗-切除手术,早期康复,和抗痛-似乎是治疗骨瘤的最佳方法,效果满意。仅在功能障碍的情况下才需要手术,而不仅仅是基于影像学检查。
Our retrospective study of burn patients presents a three-step treatment of heterotopic ossification: excision surgery, early rehabilitation, and analgesia. We included patients admitted to the department for treatment of postburn heterotopic ossification between January 1, 1979, and September 30, 2015. The mean age at the time of the burn was 43.3 years. Men accounted for the majority of burn patients who developed an osteoma (70.8%). The mean total skin area burned was 38.4%. No osteoma justifying surgery was found for any patient with a total burned skin area less than 19%. The burned zones were related to the osteoma development in 94.3% of cases. On average, the surgery took place 10.8 months after the burn. The osteotomy was accompanied by surgical treatment of a contracture in 37.1% of patients. Most of the osteomata were found at the elbows (30), followed by the shoulders (3), and finally the knees (2). Rehabilitation began on D0 after the surgery, except if a flap or a thin-skin graft was used. Regarding analgesia, opiates were prescribed systematically during the immediate postoperative period. Elbow range of motion on flexion improved by a mean of 84.1°. During the postoperative period, we found 2 recurrences of osteoma and 1 elbow hematoma in two separate patients. There were no postoperative infections or neurological sequelae. Our retrospective French study confirmed results found in the international literature. The three-step treatment - excision surgery, early rehabilitation, and antalgia - seems to be the best means of treating osteoma with satisfactory results. Surgery is indicated only in the case of functional impairment and not simply based on imaging.