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Heterotopic ossification in victims of the London 7/7 bombings
  1. D S Edwards1,2,
  2. J C Clasper2,3 and
  3. H D L Patel4
  1. 1Centre for Blast Injury Studies, Imperial College, South Kensington, London, UK
  2. 2Royal Centre for Defence Medicine, Surrey, UK
  3. 3Ministry of Defence Hospital Unit, Frimley Park Hospital, Surrey, UK
  4. 4St Bartholomew's and The Royal London Hospitals, London, UK
  1. Correspondence to D S Edwards, Centre for blast injury studies, Imperial College, South Kensington, London SW7 2AZ, UK; taffedwards100{at}


Heterotopic ossification (HO) is the formation of bone at extraskeletal sites. Over 60% of amputees injured by improvised explosive devices in the recent conflict in Afghanistan have developed HO, resulting in functional impairment. It is hypothesised that a key aetiological factor is the blast wave; however, other environmental and medical risk factors, which the casualties have been exposed to, have also been postulated. The suicide terrorist bombings in London in 2005 resulted in many blast-related casualties, many of whom were managed by the Royal London Hospital. This cohort of severely injured patients whose injuries also included trauma-related amputations shared some, but not all, of the risk factors identified in the military population. We reviewed these patients, in particular to assess the presence or absence of military-established risk factors for the formation of HO in these casualties.

  • Blast injury
  • Amputation

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