Burn Injuries And Contractures

Burn injuries damage skin and deeper tissues, triggering excessive collagen deposition during healing that forms hypertrophic scars and contractures. These joint restrictions arise from myofibroblast contraction and wound shrinkage, most common on flexor surfaces like neck, axilla, elbow, and fingers due to natural positioning.

Severity correlates with burn depth: superficial heal well, but deep second- or third-degree burns heighten risk. Early signs include stiffness, reduced range of motion (ROM), and pain. Untreated, contractures cause deformities, impair function, and affect deeper structures like muscles, tendons, or nerves.

Prevention starts immediately post-burn: positioning in extension, splinting, compression garments, silicone sheets, and aggressive physical/occupational therapy promote mobility. Massage, stretching, and laser therapy soften scars.

For established contractures, non-surgical options like serial casting or shockwave therapy precede surgery. Surgical release via Z-plasty, local flaps, grafting, or skin expansion restores ROM, followed by intensive rehab to prevent recurrence. Multidisciplinary care optimizes outcomes, with full recovery taking months.

Complications include chronic pain and psychological impact; timely intervention preserves function and quality of life.