A CLINICAL STUDY ON MANAGEMENT OF CONTRACTURES OF UPPER LIMB FOLLOWING BURN

Akash Gupta, Sanjay Pandey, Sandeep kansal, Atul Jain

Abstract


Introduction - Post burn contracture is a common sequele occurring after burn as a result of which thousands of victims of burn are handicapped every year. Upper limb contractures are also occurring more commonly because it is most mobile part of body and likely to be involved in burn.

Aim of the study: To study various operative strategies for management of patients presenting with post burn contractures of upper limb i.e axilla,elbow and hand.

Methods : 80 patients presenting with post burn contracture were treated in our hospital.

Observation & Results : In our study , the youngest member was a 2yr old girl, and the oldest was a 70yr old man .Max no. of pts 22(27.5%) were in the age group of 21-30 yrs. In our study out of 80 patients of postburn contracture, axillary contracture was present in 20 patients(25%), elbow contracture in 10patients(12.5%), wrist contracture in 8patients(10%),finger contracture in 38patients(47.5%), while complicated contracture was present in 4patients(5%). Operative procedure constituted of mainly Release with single or multiple Z-plasty in 15patients(18.75%) Release with K-wire fixation/skin grafting in 56 patients (70%),Local flap (Cross finger) in 02 patients, Abdominal/ Groin flap in 07 patients (8.75%). In our study of 80 pts, 2 pts(20%) had flap tip necrosis, 06 pt(60%) had a graft failure, 02 pts(20%) developed re-contracture while 87.5% of pts had no complications.There was no mortality in our study.

Conclusion : In the present study of 80 cases of management of post burn contractures of upper limb it is reasonable to conclude that prevention of contracture is of utmost importance. The results were satisfactory in our study in most cases with regards to quality to coverage, & range of motion.


Keywords


Burn, Post burn contracture, Skin grafting, Z-plasty, Groin flap, CrossFinger flap.

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