MANAGEMENT OF POST BURN CONTRACTURE OF UPPER LIMB

Firdous Dar, Ratnakar Sharma, Raheel Hussan Naqvi

Abstract


Post Burn contracture is one of the most common complications of burns. Although the incidence of mortality and morbidity associated with burns
has decreased drastically over the recent past, the significant physical and aesthetic trauma associated with post burn scars and contractures is still a
challenge for the medical fraternity.
AIMS AND OBJECTIVES
Ÿ To evaluate the epidemiological factors in patients with post burn contractures involving the upper limb.
Ÿ To evaluate the outcome of various treatment modalities available for the correction of the deformities secondary to post burn contractures
involving upper limb.
MATERIALS AND METHODS: This study entailed a prospective study of 40 patients admitted in Department of Surgery Government Medical
College, Jammu with post burn contractures involving the upper limb for a period of 12 months i.e. from 1st November 2017 to 31st October 2018.
The patients were assessed as regards the cause, duration and severity of the contractures and treatment modality was planned accordingly.
RESULT: In our study of management of post burn contracture involving the upper limbs, maximum number of patients were in the age group
between 21-30 years(32.5% cases). Males outnumbered the females (62.5% cases). School going children accounted for the maximum number of
cases (30%) followed by housewives (27.5%). Domestic burn injuries were cause of post burn contractures in majority of the cases (75% cases).
Flame burns were the cause of post burn contractures in majority of the cases (70%). The right upper limb was involved by post burn contracture in
majority of the cases (65%). The hand was the most common anatomical site of post burn contracture (35% cases) followed by elbow (20% cases).
Split skin grafting was the mode of coverage after release of post burn contractures in 75% of the cases. Post operative splintage and physiotherapy
comprised one of the most important component of management of post burn contractures. In the management of post burn contracture of the upper
limb the aim of the procedure is to achieve a good functional restoration of the involved part with a durable coverage with minimal complications
and morbidity involving the donor area.
CONCLUSION : Post burn contractures are inevitable even with the best of treatment because they depend upon the depth of burn injury. Burn
contracture hinder joint mobility resulting in functional impairment and reduced quality of life. Axillary contractures limit the range of abduction,
flexion contractures of elbow limit the mobility of the upper extremity. Post burn contracture of digits can result in flexion contractures, burn
syndactyly, metacarpophalangeal extension contracture, contractures of the wrist or claw hand. In the management of post burn contractures of
upper limb the aims to achieve a good functional restoration of the involved part with a durable coverage with minimal complications involving the
donor area


Keywords


Post burn contracture, upper limb, treatment modality

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