[Reconstructive operations for scarry contractures of the shoulder joint after burns]

The article presents two methods of formation of the axilla cupola with saved skin from the area of hair growth, and when there are scarry changes. The first method allows exclusion of displacement of the axilla skin into not proper places. The second method gives better engraftment and better outcomes of operation. A method of two-stage treatment was worked out for severe contractures of the shoulder joint in order to avoid a transection of the tendons and muscles and overdistention of the vascular-nervous bundles. During the preoperative period a gradual liberation of the shoulder is to be fulfilled by means of a dosated distraction of the scars, contracted tendons and muscles. The dosated distraction is performed using a specially developed splint with a turnbuckle mechanism. Using the splint the full volume of movements was restored in 73.9% of the patients. In the rest of the cases operative treatment was used, and the distracted scarry tissues can be used as plasty material.