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Postburn contractures of the hand.

Duretti T Fufa¹, Shiow-Shuh Chuang¹, Jui-Yung Yang¹

¹Division of Hand and Upper Extremity Surgery, Hospital for Special Surgery, New York, NY; Division of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan.

The Journal of Hand Surgery

|August 27, 2014

Summary

Deep thermal injury to the hand often leads to limiting contractures. Surgical release and skin grafting are key treatments for webspace, hand, and digit contractures, with rehabilitation crucial for function.

Keywords:

Burn contractures hand reconstruction

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Area of Science:

Hand surgery
Burn sequelae management

Background:

Deep thermal hand injuries frequently result in functionally limiting sequelae, primarily contractures.
While acute care is specialized, postburn contractures often require hand surgeon intervention.

Purpose of the Study:

To outline common burn contracture patterns affecting hand function.
To review nonsurgical and operative management strategies for postburn hand contractures.
To discuss expected outcomes following treatment.

Main Methods:

Management of webspace contractures and syndactyly involves scar excision and soft tissue rearrangement or grafting.
Treatment of burn claw hand (metacarpophalangeal extension, proximal interphalangeal flexion contractures) includes scar excision and resurfacing, often with full-thickness skin grafts.
Distant tissue transfer may be necessary for exposed tendons or joints post-release.

Main Results:

Surgical excision of scar tissue and appropriate resurfacing are mainstays for contracture release.
Early motion and rehabilitation are essential to prevent contracture formation and recontracture.

Conclusions:

Hand surgeons must be familiar with burn contracture patterns and treatment options.
Comprehensive management, including surgical release and rehabilitation, can improve function after deep thermal hand injury.