Improvement in Range of Motion after Surgical Correction of Post-Burn Axillary Contractures.

Background: Axillary contractures can be very detrimental to the entire upper extremity limiting the daily activities. Reconstructive surgical intervention is frequently used to avoid future abnormalities and restore functional joint motion.

Objective: The purpose of this study is to assess the effectiveness of surgical correction of post-burn axillary contractures in improving the range of motion at shoulder joint.

Methodology: This prospective study was conducted at Burns and Plastic Surgery Centre, Peshawar from January 2021 to December 2021. Patients of all ages and either gender having post-burn axillary contractures were included in the study. Patients with electric burns, acid burns, recurrent contractures, complex contractures involving other joints and patients with bilateral axillary contractures were excluded. Data was analyzed using SPSS version 27. Paired T-test was performed to compare the preoperative and postoperative shoulder abduction angles

Results: The study included 34 patients, with male preponderance.  The mean age of the patients was 24.18 ± 11.13 years. Majority were flame-burns. Contractures were released and managed according to their degrees. There was 66.67% improvement in abduction angle in patients with type 1 contractures; 63.89% in type 2 contractures; and 50% in type 3 contractures. The overall difference in abduction angles was highly significant (t=-68.42, p < 0.001). Post-operative complications were noted in 05 patients.

Conclusions: The type of surgical treatment used to correct post-burn axillary contractures is determined by the pattern of scar contracture and the condition of the surrounding skin. Timely and effective release can significantly improve function by restoring near-normal range of motion at the shoulder joint.

Keywords: Post-burn axillary contractures, surgical management, skin grafts, physiotherapy, Z-plasty, Burns.

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