Orthopaedics, USU-Walter Reed Department of Surgery Walter Reed National Military Medical Center, Bethesda, MD, United States.
Orthopaedics, USU-Walter Reed Department of Surgery Walter Reed National Military Medical Center, Bethesda, MD, United States..
Bone. 2018 Apr;109:3-11. doi: 10.1016/j.bone.2018.02.009. Epub 2018 Feb 17.
Heterotopic ossification, the formation of bone in soft tissues, is a common complication of the high-energy extremity trauma sustained in modern armed conflict. In the past 15years, military treatment facilities and aligned laboratories have been in a unique position to study and treat this process due to the high volume of patients with these injuries secondary to blast trauma. The devastating nature of these wounds has limited traditional therapeutic options, necessitating alternative solutions to prophylaxis and initial treatment producing substantial advances in modeling, prophylaxis, detection, and therapy. Specific developments include establishment of an animal model that reproduces the systemic and local tissue injury of blast injuries, the use of molecular assays and predictive modeling in clinical decision making, advances in early detection including Raman spectroscopy, and investigation of prophylactic and therapeutic pharmacotherapy targeting the molecular pathways of aberrant bone formation. In this review article, we will present the literature to date, ongoing studies, and future directions for investigation of heterotopic ossification, with a focus on military-specific research.
异位骨化，即在软组织中形成骨，是现代武装冲突中高能肢体创伤的常见并发症。在过去的 15 年中，由于大量因爆炸伤而导致此类损伤的患者，军事治疗机构和相关实验室处于研究和治疗该过程的独特位置。这些伤口的破坏性极大限制了传统的治疗选择，需要替代方案来预防和初始治疗，从而在建模、预防、检测和治疗方面取得了重大进展。具体的进展包括建立了一种可复制爆炸伤全身和局部组织损伤的动物模型，在临床决策中使用分子分析和预测模型，以及在早期检测方面的进展，包括拉曼光谱，以及针对异常骨形成的分子途径的预防性和治疗性药物治疗的研究。在这篇综述文章中，我们将介绍迄今为止的文献、正在进行的研究以及异位骨化的未来研究方向，重点是军事特定的研究。
