scholarly journals Post burn flexion contracture of hand: a prospective study

2019 ◽  
Vol 6 (8) ◽  
pp. 2823
Author(s):  
Subbu Pilla Lakshmi Bai ◽  
Raman Gunasekaran
Keyword(s):  
Functional Outcome ◽  
Graft Loss ◽  
Skin Grafting ◽  
Flexion Contracture ◽  
Complication Rates ◽  
Thermal Burns ◽  
Contracture Release ◽  
A Prospective Study ◽  
Electrical Burns ◽  
Standardization Of Procedures

Background: Burn contracture of the hand can cause severe functional and psychological deprivement in patients. This study mainly concentrates on different types of hand deformity cases presenting to our department and the various options used to correct them. The postoperative functional outcome is also compared so that standardization of procedures can be done. This study assesses the severity of the deformity, the success of various reconstruction options and the functional outcomes of cosmetic procedures.Methods: This work includes the study of 60 patients who underwent reconstruction for post-burn flexion contracture of the hand including fingers, in the department of plastic surgery, Government Rajaji Hospital, Madurai. The patients were treated between September 2009 to February 2012.Results: Males were twice commonly affected by burn injuries and thermal burns were more common than electrical burns. The little finger was more frequently involved and contracture release followed by grafting was the commonly done reconstructive procedure. Complications like recurrence, residual contracture, partial graft loss and infection were noted.Conclusions: Contracture release by multiple Z–plasty with or without skin grafting was sufficient in most cases of contracture due to thermal burns. Flaps were required for reconstructing electrical burns. Complication rates are higher in children than in adults and postoperative physiotherapy and splinting is mandatory to achieve a better functional outcome.

MANAGEMENT OF POST BURN CONTRACTURE OF NECK IN A TERTIARY BURN CARE CENTRE

2021 ◽  
pp. 33-35
Author(s):  
Nangineedi Nagaprasad ◽  
Karthik G B
Keyword(s):  
Surgical Planning ◽  
Skin Grafting ◽  
Burn Care ◽  
Split Skin Grafting ◽  
Contracture Release ◽  
Common Problems ◽  
A Prospective Study ◽  
Split Skin ◽  
Burn Contractures

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.

scholarly journals Study of soft tissue reconstruction in postburn flexion contracture of the hand

2021 ◽  
Author(s):  
Nagaraj Gareikpatii
Keyword(s):  
Flexion Contracture ◽  
Burn Injuries ◽  
Split Thickness Skin Graft ◽  
Soft Tissue Reconstruction ◽  
Thickness Skin ◽  
Contracture Release ◽  
Tissue Reconstruction ◽  
Thermal Injuries ◽  
Electrical Burns ◽  
Burn Hand

Background: Burn contracture of the hand can leave patients with severe functional and psychological limitations. This study evaluates the severity of the deformity and various reconstructive options in post-burn hand injuries.Methods: This work includes the study of 50 patients who underwent reconstruction for post-burn flexion contracture of the hand, including fingers, in the department of plastic surgery. The patients were treated between April 2007 to April 2009.Results: Males were more commonly affected by burn injuries and thermal burns were more common than electrical burns. The little finger showed higher involvement and contracture release followed by grafting was the commonly done reconstructive procedure.Conclusions: Split thickness skin graft (SSG) were more effective in reconstruction in thermal injuries, while cross finger flaps (CFF) showed more promise in electrical injuries of the hand. 

60 Contact Hand Burns in Children: Still a Major Prevention Need

2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S39-S40
Author(s):  
Jaclyn M McBride ◽  
Kathleen S Romanowski ◽  
Soman Sen ◽  
Tina L Palmieri ◽  
David G Greenhalgh
Keyword(s):  
Graft Loss ◽  
Dorsal Surface ◽  
Skin Grafting ◽  
Secondary Surgery ◽  
Surface Areas ◽  
Palmar Surface ◽  
The Mean ◽  
Total Body ◽  
Hand Burns ◽  
Palmar Aspect

Abstract Introduction Since toddlers explore with their hands, contact burns continue to be a major pediatric problem. The purpose of this report is to review a pediatric burn unit’s 8-year experience with contact burns of the hand. Methods After IRB approval, a review of pediatric contact hand burns that occurred between 2006–2014 was performed. We examined the causes and outcomes in pediatric contact hand burns in a single pediatric burn program. Results In the 8-year span, 535 children suffered contact burns to the hand (67 per year). The majority suffered hands burns from an oven or stove (120). The other etiologies included burns from a fireplace (76), clothing iron (65), curling or straightening iron (50), and firepit or campfire (46). The mean age at time of injury was 2.62 years old, with a range of 2 months old to18 years old. Male children (339) typically burned their hands more than females (197). Locations of injury included the palmar surface, dorsal surface, fingers tips/thumb, wrist or a combination of several different areas. Most children burned the palmar aspect of their hand (384) compared to the dorsal aspect (61). These burns typically cover small total body surface areas (mean 1.08% TBSA), with only 2% of burns comprising >5% TBSA. Approximately, 84% of these patients did not need surgery, but 86 (16%) had skin grafting (usually full-thickness) and 26% needed a secondary surgery. Of those that needed more than two, the average number of procedures was 3.6. Approximately 4.1% of patients needed a tertiary surgery. Causes for tertiary surgeries included contractures and graft loss. Out of twenty-two patients that needed a third surgery, 59% were due to graft loss and 41% were due to contractures. Conclusions Contact burns to the hand continue to be a major problem for toddlers. Children are most likely to burn themselves on an oven or stove, fireplace, clothing iron or curling/straightening iron. The palmar surface of the hand is the most likely site. While most children do not require surgery, approximately 16% require grafting. A significant number of those patients need reconstructive surgery. Clearly, current prevention efforts have failed to reduce these injuries. Applicability of Research to Practice Palm burns are common in young children. Efforts should focus on preventing these injuries.

FUNCTIONAL OUTCOME OF DISTAL FEMORAL FRACTURES AND THEIR MANAGEMENT

2021 ◽  
Vol 5 (6) ◽  
Author(s):  
Raman Shrivastava ◽  
Namita Shrivastava
Keyword(s):  
Functional Outcome ◽  
Surgical Techniques ◽  
Femoral Fractures ◽  
Railway Track ◽  
Distal Femoral Fractures ◽  
Minimally Invasive Surgical ◽  
Fall From Height ◽  
Classification Management ◽  
A Prospective Study ◽  
Jawaharlal Nehru

Background: Fractures of distal end of femur are complex injuries which are difficult to manage. These fractures often are unstable and comminuted. Despite advances in surgical techniques and improvement in implants, treatment of distal femoral fractures remains a challenge in many situations. This study was done to analyse the functional outcome and this management of distal femoral fractures. Material & Methods: This study has been done between August 2008 to March 2010 on patients coming to Orthopaedics Department at Jawaharlal Nehru Hospital and Research Center, Bhilai. It is a prospective study which includes 25 patients with 10 Type A, 7 Type B and 8 Type C fractures of distal femur after fulfilling the inclusion and exclusion criteria. Results: Mean age of 47.08 years with sex incidence of 3.17:1(M:F). Mode of injury was RTA in 16, simple fall in 6, fall from height in 2 and railway track accident in 1 patient. There were 5-A1, 1-A2, 4-A3, 3-B1, 1-B2, 3-B3, 1-C1, 4-C2 and 3-C3 fractures. Results were found to be excellent in 17, good in 1, moderate in 3 and poor in 4 patients. Conclusion: We conclude that minimally invasive surgical techniques and with the availability of locking type of plates distal femoral fractures can now be dealt with more precessions and more satisfactory results can be produced. Keywords: Distal fractures, Muller Classification, Management, Femoral fractures

scholarly journals A cross-sectional study of long-term satisfaction after surgery for congenital syndactyly: does skin grafting influence satisfaction?

2018 ◽  
Vol 44 (3) ◽  
pp. 296-303 ◽  
Author(s):  
Bien R. Ferrari ◽  
Paul M.N. Werker
Keyword(s):  
Donor Site ◽  
Skin Grafting ◽  
Cross Sectional Study ◽  
Complication Rates ◽  
Skin Grafts ◽  
Sectional Study ◽  
Level Of Evidence ◽  
Cross Sectional ◽  
Scar Assessment

Syndactyly correction without skin grafting is advocated because it prevents graft-related complications and donor site morbidity. In this cross-sectional study, we compared satisfaction among patients who underwent correction with and without skin grafting to determine preference based on subjective and objective parameters. Retrospective chart analysis was performed among 27 patients (49 webs) who were seen at follow-up after a median follow-up period of 7.4 years, at which the Patient and Observer Scar Assessment Scale, the Withey score and a satisfaction survey were used. Notably, there were no significant differences in complication rates or observer rated scar scores. Although the need for an additional surgical procedure was higher after skin grafting, patient-rated satisfaction scores were similar irrespective of the use of grafting. Our data suggest that corrections can best be performed without skin grafts if seeking to minimize the need for an additional procedure, but that the use of skin grafts does not appear to affect patient satisfaction. Level of evidence: IV

scholarly journals Effect of Tourniquet Use in Ankle Arthroscopic Surgery on Postoperative Recovery: A Prospective Non- Randomized Controlled Study

2020 ◽  
Author(s):  
Tingting Huang ◽  
Haixiao Liu ◽  
Yuezheng Hu ◽  
Xinxian Xu
Keyword(s):  
Functional Outcome ◽  
Ischemia Reperfusion Injury ◽  
Ischemia Reperfusion ◽  
Arthroscopic Surgery ◽  
Randomized Controlled Study ◽  
Controlled Study ◽  
Control Group ◽  
Complication Rates ◽  
Randomized Controlled ◽  
The Mean

Abstract The aim of this prospective non- randomized controlled study was to explore the effect of tourniquet use on joint swelling, pain, functional outcome, and tourniquet- related ischemia- reperfusion injury (IRI) during ankle arthroscopic surgery.52 patients who received ankle arthroscopy were allocated to had the procedure done with the tourniquet inflated (the Control group, n= 27) or without the tourniquet inflated (the NT group, n= 25). The main outcome measures were: (1) The amount of swelling of the ankle; (2) Pain as measured by a visual analog scale (VAS); (3) The levels of MDA, IMA,TOS, TAS and OSI at 10 min before incision (T1)，after the completion of surgery (T2), and 30 min after tourniquet deflation (T3); (4) The functional outcome as measured by American Orthopaedic Foot and Ankle Society (AOFAS) ankle hindfoot score; (5) The rate of complication. All patients were reviewed at a mean follow- up of 14.2 months (range, 12- 19 months). The mean circumferences of the ankle in the NT group were significantly lower than those in the Control group on postoperative day 2 and 5 (p<0.05). The mean level of VAS in the Control group was significantly higher on postoperative day 2 (p<0.05). The outcomes of AOFAS ankle hindfoot score were comparable between groups postoperatively (p>0.05). The levels of MDA, IMA, TOS and OSI were all significantly lower in the NT group compared at T2 and T3 (p<0.05), and the level of TAS was significantly lower in the NT group at T3 (p<0.05). The complication rates of two groups were comparable (p>0.05).With the use of tourniquet during ankle arthroscopic surgery, there was increased joint swelling and pain postoperatively, and a trend toward increased levels of MDA, IMA, TOS, TAS and OSI intraoperatively. Thus, we do not recommend using a tourniquet in this type of procedure.

scholarly journals A prospective study on surgical management of lumbar spondylolisthesis with pedicle screw fixation and posterolateral fusion

2017 ◽  
Vol 3 (6) ◽  
pp. 1113
Author(s):  
Bhanu Prabha Tattari ◽  
Vamshi Varenya Nimmagadda ◽  
Johorul Islam Tapadar
Keyword(s):  
Functional Outcome ◽  
Functional Disability ◽  
Sagittal Plane ◽  
Pedicle Screws ◽  
Pedicle Screw Fixation ◽  
Posterolateral Fusion ◽  
Autogenous Bone ◽  
Lateral Fusion ◽  
Lumbar Spondylolisthesis ◽  
A Prospective Study

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">Spondylolisthesis is a subluxation of vertebral body over another in sagittal plane. Incidence of Spondylolisthesis in general population is 5-7%. No matter what the etiology is, patients usually have significant functional disability. Few studies have investigated the long term effect of pedicle screws fixation and posterolateral fusion on functional outcome. Objectives of this study were assessment of lumbar spondylolisthesis, the results of posterolateral fusion using autogenous bone graft from iliac crest and stabilization by pedicle screws fixation systemand to evaluate the clinical and radiological assessment of symptoms improvement and fusion rates of this procedure and functional outcome.</span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">A total of 30 patients of lumbar spondylolisthesis who are operated upon with posterior stabilization using Pedicle Screws fixation and postero lateral fusion satisfying inclusion and exclusion criteria and followed up between February 2015 and January 2017</span>.<strong></strong></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">The study included 30 patients; aged between 21 to 60 yrs with a mean age of 46 yrs. Average follow up was 17 months. Functional outcome assessment with Kirkadly-Willis criteria showed 90% of excellent to good outcome. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">We found in our study that posterolateral fusion with Pedicle Screws fixation minimizes dislocation, achieves adequate decompression, corrects the sagittal axis, and accomplishes fusion. We successfully achieved solid fusion with good mechanical alignment in majority of the patients.</span></p>

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