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Long-Term Outcomes in Patients Surviving Large Burns: The Musculoskeletal System

Holavanahalli, Radha K. PhD; Helm, Phala A. MD; Kowalske, Karen J. MD

doi: 10.1097/BCR.0000000000000257
Original Articles

The authors have previously described long-term outcomes related to the skin in patients surviving large burns. The objective of this study was to describe the long-term musculoskeletal complications following major burn injury. This is a cross-sectional descriptive study that includes a one-time evaluation of 98 burn survivors (mean age = 47 years; mean TBSA = 57%; and mean time from injury = 17 years), who consented to participate in the study. A comprehensive history and physical examination was conducted by a senior and experienced Physical Medicine and Rehabilitation physician. In addition to completing a Medical Problem Checklist, subjects also completed the Burn-Specific Health Scale (Abbreviated 80 item), a self-report measure used to review the level of functional adaptation. Joint pain, joint stiffness, problems walking or running, fatigue, and weak arms and hands are conditions that continue to be reported at an average of 17 years from the time of burn injury. Seventy-three percent (68 of 93) of the study sample were found to have a limitation of motion and areas most affected were the neck (47%), hands (45%), and axilla (38%). The global (Burn-Specific Health Scale-total) score for the overall sample was 0.78. Subjects with limitation of motion had significant difficulty in areas of mobility, self-care, hand function, and role activities. This study underscores the importance of long-term follow-up care and therapeutic interventions for survivors of major burn injury, as they continue to have significant and persistent burn-related impairments even several years following injury.

From The Department of Physical Medicine and Rehabilitation, University of Texas Southwestern Medical Center, Dallas.

The contents of this work were developed under a grant from the Department of Education, NIDRR Grant Numbers H133A020104 and H133A120090. However, these contents do not necessarily represent the policy of the Department of Education, and you should not assume endorsement by the Federal Government.

Address correspondence to Radha K. Holavanahalli, PhD, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, 75390-9136. Email: radha.holavanahalli@utsouthwestern.edu.

© 2016 The American Burn Association