Heterotopic Ossification in adults following a burn: A phenomenological analysis

Miss Nichola Foster1, Associate Professor Dale  Edgar1,2,3, Winthrop Professor Fiona Wood2,3, Dr Rachel  Kornhaber4,5, Dr Sarah McGarry6

1Burn Injury Research Node, Institute for Health Research / School of Physiotherapy, The University of Notre Dame Australia, Fremantle, Perth, Australia, 2Burn Injury Research Unit, University of Western Australia, Crawley, Perth, , 3State Adult Burns Unit, Fiona Stanley Hospital, Murdoch, Perth, Australia, 4College of Health and Medicine, School of Nursing, University of Tasmania, Sydney Campus, Rozelle, Sydney, Australia, 5National Burns Center, Sheba Medical Center, Tel Hashomer, , Israel, 6School of Allied Health, Curtin University , Perth, Australia



Heterotopic Ossification (HO), the development of extra-skeletal bone in muscle and soft tissues, is a rare but severely debilitating complication of burn injury. The individual experiences of adults diagnosed with HO following a burn, remains unreported. This study sought to explore and describe burn survivors’ experiences of HO to gain a greater understanding of the clinical needs for this unique patient population.


A qualitative phenomenological methodology was used to construct themes depicting the experiences of HO in adult burn survivors’. A purposive sample of six adults diagnosed with HO, following a burn injury were recruited, and data collected through in-depth individual interviews. Interviews were analysed using Colaizzi’s phenomenological method of data analysis.


Analysis revealed 5 emergent themes: (1) Early signs and symptoms, (2) Impact on the rehabilitation journey, (3) The role of the health care professionals (4) Loss of independence and increased reliance on others and, (5) Learning to live with it: uncertainty, hope and adaptation. Eleven cluster themes highlighted the meaning of each emergent theme. These findings describe the significant impact the unique symptomology of HO had on the physical and psychosocial functioning of participants throughout the rehabilitation journey.


This research identified unique pain descriptors associated with HO compared to burn alone and determined that HO symptom onset is evident from the patient’s subjective reports prior to the presence of objective signs. Our findings highlight the need for the development of protocols that would guide best practice in early diagnosis of HO.


Nichola is a neurological physiotherapist and her main areas of clinical interest involve the acute and rehabilitation management of patients with stroke, traumatic brain injury, spinal cord injury and other neurodegenerative conditions. She is undertaking a PhD through the School of Physiotherapy at The University of Notre Dame, Australia. Her research is investigating the prevalence, risk factors, prevention and treatment of traumatic heterotopic ossification after burn, neurological and orthopaedic trauma.

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