Effectiveness of Distraction principle by External Circular Frame in correction Postburn wrist Contracture | ||
| The Egyptian Journal of Plastic and Reconstructive Surgery | ||
| Articles in Press, Accepted Manuscript, Available Online from 19 October 2024 | ||
| Document Type: Original Article | ||
| DOI: 10.21608/ejprs.2024.320553.1376 | ||
| Authors | ||
| SHERIEN METWALLY salama1; Amr Mahmoud Fayed2; Ahmed Gadallah* 3 | ||
| 1Plastic surgery Department , Ain shams university hospitals | ||
| 2Faculty of medicine , Ain shams University | ||
| 3plastic ,Reconstructive , Burn and Maxillofacial surgery department , faculty of medicine , Ain Shams university, Cairo , Egypt | ||
| Abstract | ||
| Background: Although it is preferable to prevent post-burn contractures of the upper extremities rather than cure them, many patients nonetheless experience this handicap, particularly following serious burns or inadequate primary care. Plastic surgeons find Post burn Fixed Flexion Deformity (FFD) of the wrist to be difficult to treat because to its intricacy and severe impact on patient impairment. Even though post burn flexion contractures deformity has been treated with surgical release and reconstruction extensively, the surgery is not without major difficulties, and the degree of rectification is not always sufficient. Aim: This case series study was conducted to evaluate the effectiveness and safety of Ilizarov's principles of distraction neo histiogenesis and differential distraction as a minimally invasive technique for correction of post burn soft tissue contracture deformity of the wrist joint without any concurrent bony procedures to prevent the risks associated with release and reconstructive surgery and to achieve long-term improvement with no complication or recurrence Results: A total of 15 consecutive patients with a mean age of 32 years (11 to 40) had distraction for a Mean period of 25 days (21 to 30). The fixator was removed after a mean of 38 days (35 to 42) when the wrist was in neutral position followed by physiotherapy. Final Assessment after 12 months period showed improvement in functional position that allowed more active movement of the hand and appearance had markedly improved. Without any serious consequences, every patient had their deformity completely corrected. Conclusion: Although surgical release and reconstruction have been used extensively to treat severe post burn wrist flexion contractures, the degree of correction is sometimes unsatisfactory, and the procedure is not exempt from significant complications. Based on the principle of slow, gradual differential distraction, we mounted circular frame distractor to deal with joint contractures. This is a percutaneous surgery, with very mild aggression to the patient and very low iatrogenic risks. The technique is easy, the degree of correction may be almost complete, and the hospital stay is limited. | ||
| Keywords | ||
| Burn; wrist; Ilizarov; contracture; fixator | ||
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