Effectiveness of Distraction Principle by External Circular Frame in Correction of Postburn Wrist Contracture

Document Type : Original Article

Authors

The Department of Plastic, Burn and Maxillofacial Surgery, Faculty of Medicine, Ain Shams University

Abstract

Background: Although it is preferable to prevent post-burn
contractures of the upper extremities rather than to cure them,
Many patients, nonetheless, experience this handicap, particularly
following serious burns or inadequate primary care.
Plastic surgeons find Post-burn Fixed Flexion Deformity
(FFD) of the wrist to be difficult to treat because of its intricacy
and severe impact on patient impairment. Even though
Post-burn flexion contracture deformity has been treated with
surgical release and reconstruction extensively, the surgery is
not without major difficulties, and the degree of rectification is
not always sufficient.
Objective: This case series study was conducted to evaluate
the effectiveness and safety of Ilizarov’s principles of distraction
neo histiogenesis and differential distraction as a minimally
invasive technique for correction of post burn soft tissue
contracture deformity of the wrist joint without any concurrent
bony procedures to prevent the risks associated with release and
reconstructive surgery and to achieve long-term improvement
With no complication or recurrence.
Results: A total of 15 consecutive patients with a mean age
of 32 years (11 to 40) had distraction for a Mean period of 25
days (21 to 30). The fixator was removed after a mean of 38
days (35 to 42) when the wrist was in neutral position, followed
by physiotherapy. Final Assessment after a 12-month period
showed improvement in functional position that allowed more
active movement of the hand, and appearance had markedly improved.
Without any serious consequences, every patient had
their deformity completely corrected.
Conclusion: Although surgical release and reconstruction
have been used extensively to treat severe post burn wrist flexion
contractures, the degree of correction is sometimes unsatisfactory,
and the procedure is not exempt from significant complications.
Based on the principle of slow, gradual differential
distraction, we mounted a circular frame distractor to deal with 
joint contractures. This is a percutaneous surgery, with very
mild aggression to the patient and very low iatrogenic risks.
The technique is easy, the degree of correction may be almost
complete, and the hospital stay is limited.

Keywords

Main Subjects

References

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