Contracture Severity at Hospital Discharge in Children: A Burn Model System Database Study

Area of Science:

• Pediatric Burn Care
• Rehabilitation Medicine
• Orthopedic Outcomes

Background:

• Contractures are a common complication following burn injuries, significantly impacting patient recovery and long-term function.
• Limited research exists on the prevalence and severity of contractures in pediatric burn survivors.
• Understanding contracture patterns is crucial for optimizing treatment and rehabilitation strategies in this population.

Purpose of the Study:

• To investigate the prevalence, location, and severity of joint contractures in pediatric burn patients at hospital discharge.
• To identify associations between contracture outcomes and factors such as burn size, injury severity, length of stay, and patient developmental stage.
• To provide a quantitative assessment of burn contractures in children to serve as a benchmark for clinical practice and future research.

Main Methods:

• Utilized data from the Burn Model System (1994-2003) including pediatric patients (<18 years) with at least one joint contracture at discharge.
• Examined 16 specific joint areas across the shoulder, elbow, wrist, hand, hip, knee, and ankle.
• Employed analysis of variance (ANOVA) to assess relationships between contracture severity, burn size, length of stay, and age groupings.

Main Results:

• A total of 225 patients contributed 1597 contractures, with the hand being the most affected site (758 contractures).
• Patients averaged 7.1 contractures each, with a median of 4.
• Mean contracture severity varied by joint, ranging from 17% loss of motion (elbow extension) to 41% (ankle plantarflexion).
• Statistically significant correlations were found between active range of motion loss and burn size, length of stay, and patient age group.

Conclusions:

• This study provides a quantitative overview of burn contractures in pediatric patients at hospital discharge using multicenter data.
• Injury size is a significant predictor of range of motion loss, underscoring the morbidity associated with severe burns in children.
• The findings offer a valuable reference for assessing range of motion outcomes in pediatric burn survivors, aiding quality improvement and future research.