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Acute Burns And Post Burn
Deformity Correction

Acute Burns And Post Burn Deformity Correction

One of the top three locations for burns scar contracture deformity is the hand. The ability of the hands to work is one of the key factors affecting the quality of life for burn survivors. Despite being generally avoidable, burn deformities do happen when the proper care is not given when they are acute or when they are a component of a big burn. The function of the hands can be significantly enhanced by reconstructive treatments. A burns survivor can benefit from choosing the right techniques and timing for surgery, then receiving supervised physical therapy.

The ability of the hands to work is one of the key factors affecting the quality of life for burn survivors. If bilateral, postburn hand malformations can render a burn survivor completely wheelchair-bound. The issue is mostly avoidable with competent first care, which would involve elevating the hand, using the proper splinting, grafting serious burns early, and receiving supervised physical therapy. Tredget[1] discovered that 54% of patients who experienced burns to the hand and upper extremities had a mean total body surface area burn of 15%. The probability of developing a deformity is substantial due to the high frequency of hand burns. One of the top three locations for burn scar contracture deformities is the hand.

The interphalangeal joints flex and the metacarpophalangeal joints extend excessively in the classic dorsal hand deformity, causing the fingers to claw. The metacarpophalangeal joints become hyperextended as a result of the significant oedema on the dorsum of the hand. Flattening of the palmar arches. This oedema-induced stress on the common digital extensor tendon system and contemporaneous hyperextension of the MP joints lead to flexion of the PIP joint. 65% of the time, the ring and little fingers are impacted.

Extensor tendons undergo adaptive shortening as the joints stiffen up over time. Due to stretch and ischaemia, the extensor tendon at the PIP joint may be exposed due to the poor condition of the skin there. The thumb may have a small initial web space and lie in the plane of the palm.

The purpose of treatment is to facilitate the thumb’s ability to oppose the tips of the other fingers, straighten the fingers, and flex the MCP joints. If the IP joints have a fixed flexion deformity, they must be freed before to or concurrently with the repair of the MCP joints’ hyperextension deformity.

With reservoirs of skin covering the joints, the skin over the MCP and IP is very flexible. It has been shown that by switching from a position of full finger extension to full fisting, there is a noticeable increase in finger length. The phalanges articulate around the head of the antecedent segment to explain the lengthening rather than moving like a door hinge. When restoring skin after dorsal release, this point must be kept in mind.



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