Heterotopic ossification: can early surgery be performed, with a positive bone scan?

It has been previously suggested that the surgical removal of areas of heterotopic ossification in patients with burns should be delayed until bone scans return to normal. The present study describes a patient who underwent surgical removal of heterotopic ossification from both elbows, 1 year after burn injury, with strongly positive bone scans, because of progressive ulnar nerve compression. Subsequently, 7 years after burn injury and 6 years after this surgery, the patient maintained an excellent range of motion in both elbows. At this time, his bone scans continue to be strongly positive. Didronel (Norwich Eaton, Norwich, N.Y.), a diphosphonate, may have played a role in this patient's recovery by decreasing bony deposition following surgery.