Management of post burn hand deformities

Abstract

The hand is ranked among the three most frequent sites of burns scar contracture deformity. One of the major determinants of the quality of life in burns survivors is the functionality of the hands. Burns deformities, although largely preventable, nevertheless do occur when appropriate treatment is not provided in the acute situation or when they are part of a major burns. Reconstructive procedures can greatly improve the function of the hands. Appropriate choice of procedures and timing of surgery followed by supervised physiotherapy can be a boon for a burns survivor.

Neglected post burns contracture of hand in children: Analysis of contributory socio-cultural factors and the impact of neglect on outcome

“…10,24,25 In our series we used Z/V-Y advancement flaps, free skin graft, free flaps and cross finger flaps.…”

Pattern of Post Burn Contracture of Hand in Eastern India

“…A number of methods using basic reconstructive techniques have been proposed which include contracture release and grafting, cross finger flaps, side finger flaps, Z-plasty, V-Y advancement flaps and local advancement flaps. [3] Fufa et al in their study concluded that the mainstays of management of these contractures include complete surgical excision of scar tissue and resurfacing of the resultant soft tissue defect, most commonly with full-thickness skin grafts. If scar contracture release results in major exposure of the tendons or joints, distant tissue transfer may be required.…”

“…Sabapathy S.R were of the opinion that the problem of post burn contracture is largely preventable by good initial care, which would include elevation of the hand, appropriate splinting, early grafting of deep burns and supervised physiotherapy. [3] Some authors. [1] have observed that despite appropriate initial management, contractures are common.…”

“…[2] The problem of post burn contracture is largely preventable by good initial care, which would include elevation of the hand, appropriate splinting, early grafting of deep burns and supervised physiotherapy. [3] Once contractures develop, correction of both functional and aesthetic deformities is indicated. While reconstructing a burnt hand, the burn surgeon must concentrate on restoring function than just on increasing the range of movement of individual joints.…”

“…V-Y plasty, Z-plasty are other options. [3,4] This study was conducted with the aim to observe different patterns of posttraumatic contracture in hand producing variable positional deformity and functional impairment and to assess the result of various treatment modalities in minimizing the effect of postburn contracture of hand.…”