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Spinal Deformities in Pediatric Burn Patients
Darrell L Moulton1, David A Yngve1, E Burke Evans1
1Department of Orthopaedic Surgery and Rehabilitation, The University of Texas Medical Branch, Galveston, TX, USA.
Insights
Pediatric third-degree burns can lead to spinal deformities like scoliosis. Extensive burns in young children increase the risk of severe spinal curves requiring treatment.
Area of Science:
- Pediatric Orthopedics
- Burn Surgery
- Spinal Deformity
Background:
- Extensive third-degree burns in children can cause spinal deformities.
- Spinal deformities, including scoliosis and kyphosis, are a potential complication in pediatric burn survivors.
Purpose of the Study:
- To investigate the incidence and characteristics of spinal deformities in pediatric patients with extensive third-degree burns.
- To identify risk factors associated with the development of severe spinal deformities post-burn.
Main Methods:
- Retrospective review of 41 pediatric patients with spinal deformities (scoliosis or kyphosis) treated at Shriners Hospital for Children.
- Analysis of patient records to determine age at burn, age at follow-up, curve type, curve severity, and scar characteristics.
Main Results:
- Forty-one pediatric patients (39 with scoliosis, 1 with kyphosis) were identified.
- Common curve types included thoracolumbar (21 patients) and thoracic (16 patients).
- Contractile burn scar on the trunk was present on the concavity of the curve in all patients.
Conclusions:
- Mild scoliosis is common after pediatric burns, but extensive burns at a young age can result in severe spinal curves.
- Risk factors for severe curves include trunk-spanning scars, young age at burn, large total body surface area burns, and high percentage of third-degree burns.
- Treatment options range from conservative measures like bracing to surgical interventions such as posterior stabilization for severe cases.
Introduction:
Extensive third-degree burns in pediatric patients can be associated with the development of spinal deformities.
Methods:
Forty pediatric burn patients with scoliosis and one with kyphosis were identified based on a retrospective review of patient records at the Shriners Hospital for Children in Galveston, Texas.
Results:
Average age at time of burn was 7 years 4 months. Average age at follow-up was 11 years 10 months. Twenty-one patients had a thoracolumbar curve, with an average of 20 degrees. Sixteen patients had a thoracic curve, with an average of 16 degrees. Three patients had a lumbar curve, with an average of 9 degrees. Five patients had scoliosis greater than 40 degrees. The kyphosis was 90 degrees. All patients had contractile burn scar on the trunk on the concavity of the curve.
Discussion:
Mild scoliosis curves are common following third-degree burns in the pediatric population, but extensive burns at a young age can cause severe curves. Risk factors include burn scar traversing the entire length of the trunk, young age, greater total body surface area burn, and greater percentage of third-degree burn. Soft tissue procedures and bracing may be used to treat flexible curves. Posterior stabilization may be needed for more severe curves.
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