Burn Contracture Release

Background: Post burn contracture is one of the most common problems in our country and usually seen in lower socio-economic people. Burn contractures of the neck can produce a signicant impact on quality of life by reducing a patient's ability to perform activities of daily living Methods: A prospective study was conducted with a sample size of 30 patients with post burn neck contracture conducted for a duration of 24 months. After meticulous surgical planning, patients underwent contracture release and split skin grafting/z-plasty followed by rigorous splintage and physiotherapy. Majority of the patients were in the age group of 11-30 years (63%).70% of the Results: patients sustained burns in the range of 21-40% and 80% were due to ame burns.46.66% (14) of patients had severe contracture while 13.33% (4) had extensive mento-sternal adhesions. 90% of the patients underwent release + SSG while 10% underwent z-plasty. Postoperatively cervico-mental angle of 100-120 degrees was achieved Skin grafting is a simple, reliable and safe operation however postoperative splinting is n Conclusion: ecessary. The use of skin grafts continues to deliver excellent results with adequate restoration of cervico-mental angle.

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Surgical Treatment for Malunion of the Lateral Humeral Epicondyle with Posterior Subluxation of the Radial Head: A Case Report and Literature Review

Case Reports in Orthopedics ◽

10.1155/2018/1901235 ◽

2018 ◽

Vol 2018 ◽

pp. 1-4

Author(s):

Koichi Yano ◽

Yasunori Kaneshiro ◽

Hideki Sakanaka

Keyword(s):

Lateral Collateral Ligament ◽

High Energy ◽

Limited Range ◽

Forearm Rotation ◽

Collateral Ligament ◽

Lateral Epicondyle ◽

Limited Range Of Motion ◽

Contracture Release ◽

Normal Congruence ◽

The Right

A 24-year-old right-handed man suffered right olecranon and lateral epicondylar fracture from high energy trauma. Fixation of olecranon was performed by a previous doctor. Three months after operation, he presented with limited range of motion (ROM) of the right elbow caused by malunion of the lateral epicondylar fracture and subluxation of the radiohumeral joint. Preoperative ROM of the right elbow was flexion 110° and extension −75°. Forearm rotation was pronation 85° and supination 65°. Fragment excision of the lateral epicondyle, which was 27 mm in length, and lateral collateral ligament repair using anchors were performed. Fourteen months postoperatively, contracture release of the elbow was performed. Twenty-four months postoperatively, radiograph of the elbow showed normal congruence without osteoarthritic changes and the ROM of the right elbow was flexion 120° and extension −35°. Forearm rotation was pronation 90° and supination 70°. In the surgical setting, in case of the size of the lateral epicondylar fragment is relatively large, the fragment should be fixed or lateral collateral ligament should be repaired when the instability of the elbow is found.

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Manual Kirschner-Wire Insertion through the Soft Tissue for Finger Immobilization after Scar Contracture Release

Journal of the Korean Society for Surgery of the Hand ◽

10.12790/jkssh.2015.20.1.8 ◽

2015 ◽

Vol 20 (1) ◽

pp. 8

Author(s):

Jun Hee Lee ◽

Kang Woo Lee ◽

Jin Sik Burm ◽

Won Yong Yang ◽

Sang Yoon Kang

Keyword(s):

Soft Tissue ◽

Kirschner Wire ◽

Scar Contracture ◽

Contracture Release

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Tumescent local anesthesia as an alternative to general anesthesia in release of post-burn neck contracture and skin graft harvesting: A comparative study

Anaesthesia, Pain & Intensive Care ◽

10.35975/apic.v25i1.1434 ◽

2021 ◽

Vol 25 (1) ◽

Author(s):

Mukesh Kumar Prasad ◽

Payal Jain ◽

Rohit Kumar Varshney ◽

Aditi Khare ◽

Gurdeep Singh Jheetay

Keyword(s):

Postoperative Pain ◽

Pain Relief ◽

Blood Loss ◽

General Anesthesia ◽

Local Anesthesia ◽

Skin Graft ◽

Tumescent Local Anesthesia ◽

Graft Harvest ◽

Contracture Release ◽

Split Skin

Background: Anesthetic management of severe post burn neck contracture is difficult, demanding due to fixed flexion deformity of neck, incomplete oral occlusion and insufficient mouth opening leading to difficulty in intubation. Patients undergoing contracture release, skin graft harvest under general anesthesia (GA) were compared with patients undergoing the same surgery under tumescent local anesthesia (TLA) technique. Methodology: Twenty-one patients with post burn neck contracture undergoing contracture release with split skin grafting under GA were compared with twenty-one patients undergoing the same surgery under TLA. Post-operative pain and satisfaction were assessed using 10 cm VAS (Visual Analogue Scale). Results: Demographic profile was comparable in both groups. Changes in intra-operative vital parameters remained insignificant. The average volume of tumescent solution used was 254.76 + 49.05ml. Blood loss was significantly decreased, postoperative pain relief was more than sixteen hours in thirteen patients and extended beyond twenty-four hours in six patients in the TLA group. Time for the first rescue analgesia was significantly lesser in the GA group and the average dose of injection tramadol used in the GA group was significantly higher within the first 24 h. Overall satisfaction in the TLA group was significantly higher than in the GA group. Conclusion: TLA can be used as sole technique for release of post burn neck contracture and harvest of split skin grafts with less blood loss and significantly better postoperative pain relief avoiding complications of general anesthesia. Key words: Tumescent local anesthesia; Post burn neck contracture; Skin graft harvest; General anesthesia Citation: Prasad MK, Jain P, Varshney RK, Khare A, Jheetay GS. Tumescent local anesthesia as an alternative to general anesthesia in the release of post-burn neck contracture and skin graft harvesting: A comparative study. Anaesth. Pain intensive care 2021;25(1):34–39. DOI: 10.35975/apic.v25i1.1434 Received: 18 February 2020, Reviewed: 16 March 2020, Accepted: 30 April 2020

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Skin Grafting

Operative Plastic Surgery ◽

10.1093/med/9780190499075.003.0007 ◽

2019 ◽

pp. 65-72

Author(s):

Stephen M. Milner

Keyword(s):

Skin Grafting ◽

Skin Grafts ◽

Full Thickness ◽

Preoperative Preparation ◽

Scar Contracture ◽

Skin Defects ◽

Full Thickness Skin ◽

Thickness Skin ◽

Contracture Release

Skin grafting is an indispensable technique used in a variety of clinical situations, including acute burns, traumatic wounds, scar contracture release, and oncological and congenital deficiencies. The author’s preferred techniques for harvesting and resurfacing various skin defects using split- and full-thickness skin grafts are described in this chapter, together with the assessment of donor and recipient sites, preoperative preparation and postoperative considerations.

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DRUJ Contracture Release

Techniques in Hand and Upper Extremity Surgery ◽

10.1097/00130911-199903000-00003 ◽

1999 ◽

Vol 3 (1) ◽

pp. 13-22 ◽

Cited By ~ 5

Author(s):

WILLIAM B. KLEINMAN

Keyword(s):

Contracture Release

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Linear Hand Burn Contracture Release under Local Anesthesia without Tourniquet

Hand Surgery ◽

10.1142/s0218810415720272 ◽

2015 ◽

Vol 20 (03) ◽

pp. 484-487 ◽

Cited By ~ 2

Author(s):

Theddeus O.H. Prasetyono ◽

Astrid F. Koswara

Keyword(s):

Local Anesthesia ◽

Male Patient ◽

Ring Finger ◽

Operative Field ◽

Hemostatic Effect ◽

Contracture Release ◽

Tumescent Solution ◽

The One ◽

Without Tourniquet

The objective of this report is to present a case of hand burn linear contracture release performed under local anesthesia. It also introduces the one-per-mil tumescent solution consisted of 0.2% lidocaine and 1:1.000.000 epinephrine as a local anesthesia formula, which has the potential of providing adequate anesthesia as well as hemostatic effect during surgery of the hand without tourniquet. The surgery was performed on a 19 year-old male patient with multiple thumb and fingers flexion linear contracture for 105 minutes without any obstacle. The patient did not complain any pain and discomfort during the procedure; while bloodless operative field was successfully achieved. At four-month follow up, the patient could fully extend his thumb, middle and ring finger, while the index was limited by 10° at the DIP joint. Overall, the patient was satisfied with the outcome.

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