Heterotopic Ossification and Hypertrophic Scars

Clin Plast Surg. 2017 Oct;44(4):749-755. doi: 10.1016/j.cps.2017.05.006. Epub 2017 Jul 10.


Burns and trauma cause superficial and deep soft tissue wounds that cannot heal to the preinjury state. Healing requires cell proliferation and differentiation into the injured tissue type, laying down extracellular matrix, often as collagens. Heterotopic ossification causes severe pain, nonhealing wounds, and restricted range of motion. Treatment includes radiation therapy, nonsteroidal anti-inflammatory drugs, bisphosphonates, and possibly surgical excision and prophylactic measures. Hypertrophic scars, nonosseous lesions caused by excessive collagen deposition, are often painful, functionally limiting, and aesthetically displeasing. Treatment includes CO2 laser application, steroid injections, and excision with skin grafting. This article reviews the management of these pathologic wounds.

Keywords: Burn injury; Heterotopic ossification; Hypertrophic scar.

Publication types

  • Review

MeSH terms

  • Burns / complications*
  • Cicatrix, Hypertrophic / etiology
  • Cicatrix, Hypertrophic / therapy*
  • Humans
  • Ossification, Heterotopic / diagnostic imaging
  • Ossification, Heterotopic / etiology
  • Ossification, Heterotopic / therapy*
  • Radiotherapy
  • Skin Transplantation
  • Wound Healing