J Korean Soc Plast Reconstr Surg.  1999 Jul;26(4):567-574.

Analysis and Treatment of Postburn Hand Deformities Durn to Burn Scar Contracures in Children

• Kim MG
• Seo HH

Abstract

Though proper management of hand burns in children is provided, hypertrophic scars frequently cause various hand deformities or functional disturbances in growing hands. When correction principles have not been observed for the long term, contraction of the skin, tendon and joints has a serious influence on hand deformities and bone change occur in growing children and second, to determine when is the proper operative time to minimize hand deformities and recurrences. We reviewed 107 hands in 103 admitted pediatric patients who had postburn hands deformities by scar contracture. The analysis of severity of hand deformities was evaluated by assessment of our hospital scale. According to these data, we performed the operations and compared the final results. The results were as follows: The types of burn hand deformities among 107 involved hands of 103 patients included flexion contracture (39.3%), syndactyly (29.9%), extension contracture (10.3%), Boutonniere deformity (9.3%), claw hand deformity (5.6%), severe hypertrophic scar (3.7%), swan neck deformity (0.9%), and loss of digit (1.9%) etc. On 98 preoperative x-ray examinations, bone changes were common, including angular deformity (19.4%), epiphyseal plate loss(18.4%), osteoporosis (17.3%), bony erosion (17.3%), joint change (15.3%), and ankylosis (9.2%). Thus, early correction of postburn hand deformities is imperative in pediatric patients, even though there is a greater chance of secondary operation due to immature scars. All patients were operated on by our proposed protocol and postoperative results showed greatly improved finger joint motion than before. We concluded that early correction of Grade III to V postburn hand deformities is mandatory in rapidly growing pediatric patients.

MeSH Terms

Animals
Ankylosis
Burns*
Child*
Cicatrix*
Cicatrix, Hypertrophic
Congenital Abnormalities
Contracture
Finger Joint
Growth Plate
Hand Deformities*
Hand*
Hoof and Claw
Humans
Joints
Neck
Operative Time
Osteoporosis
Recurrence
Skin
Syndactyly
Tendons