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An Individualized Approach to Severe Elbow Burn Contractures

Kung, Theodore A. M.D.; Jebson, Peter J. L. M.D.; Cederna, Paul S. M.D.

Plastic & Reconstructive Surgery: April 2012 - Volume 129 - Issue 4 - p 663e–673e
doi: 10.1097/PRS.0b013e3182450c0c
Hand/Peripheral Nerve: Special Topic
Advanced

Summary: Contracture of the antecubital fossa is a common occurrence following thermal burn injury to the upper extremity. Scarring of the superficial tissues can be treated with a variety of surgical methods to provide release and coverage. However, complex scarring of the elbow, which involves the deeper structures, requires a patient-specific technique for which each scarred, shortened, or contracted component is purposefully addressed during the operation. In addition, severe elbow contractures may be complicated by other conditions, such as peripheral neuropathy and heterotopic ossification. This article will discuss the evaluation of the patient with a severe elbow burn contracture and emphasize the importance of an individualized and comprehensive surgical approach.

CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, V.

Ann Arbor and Grand Rapids, Mich.

From the Department of Surgery, Section of Plastic and Reconstructive Surgery, University of Michigan Health Systems; Michigan State University School of Human Medicine; and Grand Rapids Medical Education Program, Department of Orthopedic Surgery.

Received for publication April 22, 2011; accepted October 17, 2011.

Disclosure: Dr. Jebson receives book royalties from Elsevier. The other authors have no related financial interests to disclose. This article did not require any sources of funding.

Paul S. Cederna, M.D.; University of Michigan Health Systems, Department of Surgery, Section of Plastic and Reconstructive Surgery, 1500 East Medical Center Drive, 2130 Taubman Center, SPC 5340, Ann Arbor, Mich. 48109, cederna@med.umich.edu

©2012American Society of Plastic Surgeons