Correlation between Post-Burn Hypertrophic Scar Characteristics and Upper Limb Functional Performance: A Cross-Sectional Study

Background: Post-burn hypertrophic scars are a prevalent complication following dermal injuries, significantly affecting upper limb functionality. Purpose: This study was conducted to investigate the correlation between the characteristics of post-burn hypertrophic scars and functional performance in the upper limb. Patients and methods: A cross-sectional study that was conducted on 80 patients of both genders, aged 20-50 years, suffering from post-burn hypertrophic scars on the upper limb. Scar severity was assessed using the Modified Vancouver Scar Scale (MVSS). Functional performance was evaluated using the Arabic version of the disabilities of the arm, shoulder, and hand questionnaire (DASH). Scar surface area was assessed using imito photography app. Correlation analysis was used to assess the relationships among scar surface area, characteristics and functional disability. Results: Mean total MVSS score showed strong positive correlation with pliability (r=0.861), height (r=0.779), vascularity (r=0.8) and pigmentation (r=0.683), all at (p < 0.001). Mean MVSS score was moderately correlated with DASH score (r=0.516, p < 0.001). Scar height, vascularity and pigmentation showed moderate correlation with DASH score (r =0.316, p = 0.004), (r = 0.302, p = 0.006 ) and (r = 0.413, p <0.001) respectively, while Pliability showed the strongest correlation with DASH scores (r = 0.496, p < 0.001). Scar surface area was significantly correlated with pliability and DASH scores (r=0.262, p=0.019), (r=0.292, p=0.009) respectively. No significant differences in MVSS and DASH scores were found across different locations and number of anatomical regions. Conclusion: There was a significant moderate to strong correlation between all hypertrophic scar characteristics and upper limb functional performance with scar pliability was the most influential factor affecting upper limb function post-burn. Early interventions targeting pliability may improve rehabilitation outcomes.