Successful treatment of postburn flexion contracture in fingers of early childhood with dynamic splint therapy after operation: long-term follow-up

Abstract

Background

Infants or early childhood individuals are prone to be burned on the palm and fingers, since they tend to extend their hands to the heat source. Wounds with more than 3-week-prolonged ulcers frequently result in flexion contracture. Despite successful surgery, the outcome might be unsatisfactory because of postoperative contracture. This study aims to investigate the effectiveness of our dynamic splint therapy following operation of postburn flexion contracture of fingers in infants or early childhood.

Methods

Ten patients with postburn flexion contractures were enrolled in this study. After epithelialization of wounds had been completed, surgery was planned. Contracture was released by scar incision, and full-thickness skin was grafted. Postoperatively, the finger joints were fixed at the extended position with the Kirschner wires for 3 weeks. After the fixation was released, Capener-type dynamic splints were worn for 2 years. The functional outcome was assessed by measurement of total active motion (TAM). The aesthetic outcome was assessed using Vancouver scar scale (VSS).

Results

The mean postoperative follow-up period was 49.6 months (range 31–81 months). In all cases, contractures were released, and all skin grafts were completely taken. None developed late contracture. The mean postoperative TAM of the fingers (259.6 ± 2.54) was significantly higher than the preoperative one (148.0 ± 51.5). The mean postoperative VSS (1.40 ± 1.14) was significantly lower than the preoperative one (5.53 ± 0.50).

Conclusions

Our treatment protocol provided the excellent functional result and improved the aesthetic appearance.

Level of Evidence: Level IV, therapeutic study.

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