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Manual External Skeletal Distraction of Restricting Soft Tissue after Release of Long-Standing Burn Contractures
Bharatendu Swain1, C Shravya1, Shalini Sampreethi1
1Aakar Asha Hospital, Kukatpally, Hyderabad, Telangana India.
Background:
Long-standing burn contractures of limb joints are resistant to complete surgical release and have been addressed earlier by serial casting, and more recently, distraction with a distractor, mostly limited to small joints of the hand. This retrospective study of patients with long-standing burn contracture was done to evaluate the efficacy of external skeletal distractors in securing complete release of various affected joints.
Materials And Methods:
In our series, complete release was achieved through gradual manual distraction using skeletal uni- and multiplanar frameworks across the affected limbs after incisional release. The resultant wound after complete release was skin grafted or covered with flaps.
Results:
Thirty-one limbs in 27 young patients (average age: 19 years) with long-standing contractures (18.5 years) due to burns underwent manual soft tissue distraction in order to achieve complete release (50-95 degrees across various joints). All patients achieved complete release of contractures with minimal complications.
Conclusion:
Gradual manual soft tissue distraction through external skeletal distractors of restricting soft tissue ("stretch as you go") after incisional release in long-standing burn contracture of limb joints achieves complete release without exposure of vital structures.
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