[Methods for the surgical treatment of postburn contractures of the shoulder joint]

Based on their experience with the treatment of 93 patients with postburn adduction contracture of the shoulder the authors propose a classification related with localization of scars. Marginal contractures are successfully treated by plasty with a trapezoid skin-fat flap from the axillary cavity with/without a combination with the displacement of scarry tissues or free skin plasty; the medial contracture--by one or several pairs of trapezoid skin-fat flaps cut from leaves on the sides of the scar fold; the total contracture with the absence of intact skin in adjacent fields can be adequately eliminated by mobilization a quadrangular island in projection of the dropped axillary cavity to the normal level of the cupola, fixation of narrow sides to the wound margins on the anterior and posterior surface of the humeral articulation and closure of wounds on the shoulder and chest with the splitted skin; the anterior-posterior contracture is eliminated either in the same way as the marginal one, or by cutting a quadrangular flap in the center of the axillary cavity as in the total contracture.