title: Analysis of upper extremity motion in children after axillary burn scar contracture release.
abstract: Burns to the upper extremity and axilla frequently result in the formation of contractures that can impede shoulder range of motion. The purpose of this study was to determine the long-term effects of upper extremity burn scar contracture release on motion during activities of daily living in the first year postrelease. Upper extremity motion analysis was conducted on children aged 4 to 17 years before and 1, 3, 6, and 12 months after axillary contracture release surgery. Movements were analyzed during three functional tasks including high reach (reaching for an object), hand to head (combing hair), and hand to back pocket (toileting). A total of 23 subjects (34 axillary contractures; mean age 10+/-3 years; mean TBSA burn 40+/-6%) completed the study. Preoperatively, decreased shoulder mobility due to axillary contractures resulted in the use of compensatory motions to complete the tested activities. Surgical release of the contracture increased shoulder mobility and decreased compensatory movements. Improvements were maintained for 1 year after surgery with majority of the improvement involving shoulder flexion. Axillary contracture release surgery improves functional shoulder mobility and decreases compensatory motions used during activities of daily living in the first year postrelease. Additional follow-up is needed to evaluate the impact of growth on scar development.
authors.affiliation: Shriners Hospitals for Children Northern California, Sacramento, CA 95817, USA.
authors.forename: Mitell
authors.initials: M
authors.lastname: Sison-Williamson
authors.forename: Anita
authors.initials: A
authors.lastname: Bagley
authors.forename: Kyria
authors.initials: K
authors.lastname: Petuskey
authors.forename: Sally
authors.initials: S
authors.lastname: Takashiba
authors.forename: Tina
authors.initials: T
authors.lastname: Palmieri
mesh_terms: D000203:Activities of Daily Living; D000293:Adolescent; D000704:Analysis of Variance; D001365:Axilla / Q000503:physiopathology* / Q000601:surgery*; D001696:Biomechanical Phenomena; D002056:Burns / Q000503:physiopathology*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003286:Contracture / Q000503:physiopathology* / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D011446:Prospective Studies; D034941:Upper Extremity / Q000503:physiopathology*