title: Active range of motion outcomes after reconstruction of burned wrist and hand deformities.
abstract: This works aim is to evaluate the efficacy of skin grafts and flaps in reconstruction of post-burn hand and wrist deformities. A prospective study of 57 burn contractures of the wrist and dorsum of the hand was performed. Flaps were used only if there was a non-vascularized structure after contracture release, otherwise a skin graft was used. Active range of motion (ROM) was used to assess hand function. The extension deformity cohort uniformly underwent skin graft following contracture release with a mean improvement of 71 degrees (p<0.0001). The flexion deformity cohort was treated with either skin grafts (8 patients) or flaps (9 patients) with a mean improvement of 44 degrees (p<0.0001). Skin grafts suffice for dorsal hand contractures to restore functional wrist ROM. For flexion contractures, flaps were more likely for contractures >6 months. Early release of burn contracture is advisable to avoid deep structure contracture.
authors.affiliation: University of Wisconsin, Madison, WI, USA; Cairo University, Cairo, Egypt. Electronic address: ahafifi@yahoo.com.
authors.forename: Ahmed M
authors.initials: AM
authors.lastname: Afifi
authors.affiliation: Cairo University, Cairo, Egypt.
authors.forename: Tarek A
authors.initials: TA
authors.lastname: Mahboub
authors.affiliation: Cairo University, Cairo, Egypt.
authors.forename: Amr
authors.initials: A
authors.lastname: Ibrahim Fouad
authors.affiliation: David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
authors.forename: Kodi
authors.initials: K
authors.lastname: Azari
authors.affiliation: Heart of England NHS Foundation Trust, Birmingham, UK.
authors.forename: Haitham H
authors.initials: HH
authors.lastname: Khalil
authors.affiliation: University of Wisconsin, Madison, WI, USA.
authors.forename: James E
authors.initials: JE
authors.lastname: McCarthy
mesh_terms: D000293:Adolescent; D000328:Adult; D001864:Bone Wires; D002056:Burns / Q000150:complications; D002648:Child; D002675:Child, Preschool; D003286:Contracture / Q000209:etiology / Q000601:surgery*; D005260:Female; D006227:Hand Deformities, Acquired / Q000209:etiology / Q000601:surgery*; D006230:Hand Injuries / Q000150:complications; D006801:Humans; D008297:Male; D008683:Metatarsophalangeal Joint; D008875:Middle Aged; D011446:Prospective Studies; D016059:Range of Motion, Articular; D019651:Plastic Surgery Procedures / Q000379:methods*; D016038:Skin Transplantation / Q000379:methods*; D013524:Surgical Flaps; D016896:Treatment Outcome; D014954:Wrist Injuries / Q000150:complications; D014955:Wrist Joint; D055815:Young Adult
keywords: Flap; Hand burn; Hand reconstruction; Reconstruction