An evaluation of functional improvement following surgical corrections of severe burn scar contracture in the axilla

This report present an evaluation 13 consecutive cases of severe burn scar contracture of the axilla and investigates the factors that influence functional improvement. The operation was performed at various times during the period from 3 months to 63 years after the initial burn wound healed. The active range of shoulder abduction before the operation in these patients was restricted to 30-90degrees. The scar contractures in the axilla were released in all cases and the defects of the axillary region were covered with musculocutaneous flaps or fasciocutaneous flaps. Following operation rehabilitation was performed with the range of shoulder abduction had reached a plateau. The relations between the improved range of shoulder abduction, time to reach a stable range of abduction, patient age and duration of illness in each patient are discussed. Patient with long post-injury periods required a longer time to reach a stable range of abduction. Furthermore, the patients with an extremely long period before operation had difficulties such as nerve injury or stiff joint which restricted improvement. In conclusion, adequate surgical treatment in early period after occurrence of contracture is desirable for burn scar contracture of the axilla. (C) 2003 Elsevier Science Ltd and JSBI. All rights reserved.