POST BURN CONTRACTURES FINGERS

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V Y INCISION MARKED

Lateral view





one finger done 

Lateral view of pre and post op results
Burns are common problem especially pediatric burns . In pediatric burns hand burns are special because flexor tone is more in kids . They usually healed with resulting flexion contracture of fingers.
There are neumerous ways of treating post burn contractures
Release and skin graft
Distraction 
 Z plasty
Release and flap cover
 V-Y plasty
V- Y plasty is very good way doing flexion contracture release . It gives good results as can be seen from above pictures. It is applicable in wide variety of contracture. 

Distraction lengthening is use full for very tight long standing contracture, as it lengthen nerve and other soft tissue along with lengthening scar. Multiple surgery and need for resurfacing scar is major drawback.
 Release and flap cover is usually reserved for contracture with extensive tissue Loss and need for tendon reconstruction surgery.
Release and Skin grafting is usually done in contacture which are not amenable to Z plasty or V-Y plasty. Prolonged splintage is major drawback especially in children.


Contracture is defined as scar across joint, it impair mobility of that joint. It results in downgraded joint function resulting in impaired extremity function.
Contracture arise due to tissue Loss. Cause of loss could be burns , crush injury, avulsion injury. Along with tissue loss results wide spread fibrosis which correspond to area of injury. Loss of tissue results in wide spread defect and body tries to heal it. One of the ways is to shrink the wound and body is quiet apt at it. As it pulls surrounding tissue it creates tension and it results in tension in soft tissue as a result it looks puckered up .
Not all contracture are at joints facial contracture and neck contractures are due to scar across facial features with distortion and loss of function . 




Dr Adhishwar Sharma 8860650846, adhishwar@live.com



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