Study of Post Burn Contracture of Hand, Surgical Management and Outcomes

Background: Contractures following burns are a serious sequel impacting functional ability of patient. The impact is more if hands are involved given their importance for daily tasks and earning of livelihood. Aims: To study the type of hand contractures in patients after burn injury, surgical procedures done and the outcomes after surgery. Settings and Design: Retrospective study was conducted. Records of patients undergoing surgical correction of post burn hand contractures were studied. Material and Methods: Patients were classified according to McCauley’s classification before surgery. They underwent surgical correction. Different methods were used for wound coverage. In post operative period splints were applied and physiotherapy administered. Patients were again graded as per McCauley classification at the end of one year. Results: A total of 35 patients were studied. Of these 19 were male and 16 were female. Ages ranged from one year to 28 years. Single digit involvement was seen in eight patients and both hands were involved in two patients. Methods used for hand coverage were split thickness skin grafting (STSG), full thickness skin grafting (FTSG) and local flaps. Recurrence was observed in two patients. Rest all the patients showed improvement. Conclusion: Good functional improvement can be achieved in patients of post burn hand contractures. Skin graft is reasonable method of wound coverage in these patients and flap coverage should be used when skin grafting is precluded. K-wiring is an effective method of splintage in post-operative period. Patients need to be followed up meticulously for proper splinting and physiotherapy.