Bone Mineral Density After Burn Injury and Its Relation to the Characteristics of Scar Tissue

Burn injuries are associated with the negative effects on the musculoskeletal system and are important causes of severe disabilities. The aim of this study was to evaluate bone mineral density (BMD), bone turnover markers, and 25(OH) vitamin D levels in male patients with sustained at least 1 year postburns involving more than 30% of the TBSA in comparison to a control group and evaluate the relation between the characteristics of scar tissue and BMD and 25(OH) vitamin D levels. The study included 25 male patients who previously sustained burn injuries involving more than 30% of the TBSA and 20 healthy subjects as the control group. The burn scars were assessed using the Modified Vancouver Scar Scale Score (MVSSS). BMD at the lumbar spine and femoral neck were measured. The blood tests included calcium, phosphorus, bone-specific alkaline phosphatase, thyroid stimulating hormone, parathyroid hormone, 25(OH) vitamin D, osteocalcin, and β-isomerized form C-terminal telopeptide of type I collagen. The femoral neck z score and bone mass density values, 25(OH) vitamin D3, and bone-specific ALP were significantly lower in injured compared with the control group. There was a negative correlation between MVSSS and vitamin D levels. Femoral bone loss should be taken into consideration in patients who sustain burn injuries and preventive treatment strategies must be adopted in the early treatment of burn injuries. Particularly in patients with high MVSSS should be evaluated for possible vitamin D deficiency during the long term.