OPTIMIZING DIFFERENT RESURFACING OPTIONS AFTER RELEASE OF POST BURN ELBOW CONTRACTURE: A SINGLE INSTITUTION EXPERIENCE

Harishankar Singh; Rajneesh Gour; Debarati Chattopadhyay; Firdos Ahmed

Volume : V, Issue : III, March - 2016

OPTIMIZING DIFFERENT RESURFACING OPTIONS AFTER RELEASE OF POST BURN ELBOW CONTRACTURE: A SINGLE INSTITUTION EXPERIENCE

Harishankar Singh, Rajneesh Gour, Debarati Chattopadhyay, Firdos Ahmed

Abstract :

Background: post burn elbow contracture is one of the most common joint involved among burn patients. Release and resurfacing is required to keep hand in optimal functional position. We are presenting here, our experience with different resurfacing procedures and preferred option according to the type of contracture. This study is aimed to evaluate different surgical options for resurfacing after release of post burn elbow contracture in terms of functional and aesthetic outcomes. Methods: Tthis non-randomized prospective study was done on 38 patients operated in 2 years time period. the patients with various types of elbow contractures were operated and resurfacing procedure selected according to the type of contracture. Among different described procedures in the literature author uses skin grafts, Z plasty, local advancement flap, propeller flap, reverse medial arm flap and forearm fasciocutaneous flap. Results : Conclusion: Skin grafting is a simple procedure, although requires long term postoperative splinting, has fewer complications and gives satisfactory functional and aesthetic results. Multiple Z plasty are suited for mild single band contractures. Local advancement flaps gives best functional and aesthetic results with single band contractures, however, it may have to be supplement with skin graft in case of moderate contracture. Propeller flap have advantage of giving suitable coverage over joint area along with STSG above and/or below it so that there is least chance of recurrence. Fasciocutaneous flaps like Reverse medial arm flap and forearm fasciocutaneous flaps, if possible give good functional and aesthetic results with early postoperative full range of motion exercises.