Search In this Thesis
   Search In this Thesis  
العنوان
Different surgical modalities for management of postburn flexion contracture of the elbow /
المؤلف
Ali, Hisham Taha Ahmed.
هيئة الاعداد
مشرف / هشام طه أحمد على
مشرف / شريف محمد القشطى
مشرف / أحمد محمد الباره
مشرف / شوقى شاكر جاد
الموضوع
Surgery, Operative. Therapeutics, Surgical.
تاريخ النشر
2015.
عدد الصفحات
117 p. :
اللغة
الإنجليزية
الدرجة
ماجستير
التخصص
جراحة
الناشر
تاريخ الإجازة
15/3/2015
مكان الإجازة
جامعة المنوفية - كلية الطب - جراحة عامة
الفهرس
Only 14 pages are availabe for public view

from 117

from 117

Abstract

The postburn scar is inevitable problem even with the best treatment as it depends on the depth of the burn injury, so only superficial dermal burns, heal with no scarring, but the contracture is preventable problem especially with the best treatment . The postburn elbow flexion contracture may be associated with heterotropic calcification of the elbow joint which needs orthopedic team consultation. Before attempting release, the patient should be asked to wait preferably 6-12 months from the date of the burn injury, which can be frustrating to the patient. However during this time massage, serial splinting and regular visits to the physiotherapist will pay dividends in the end. This is preferred, as it is better also to operate on mature scar which is less vascular and avoid operating on immature scar with resultant further trauma. In case of associated joints contractures, we proceed first on the most proximal then we go distally. The use of skin graft was popular in the past in the reconstruction of postburn flexion contracture after the release, but it has many disadvantages as graft loss, less aesthetic appearance than the local flaps, recontracture, prolonged splinting and physiotherapy postoperatively. Now it is spared when broadband contracture and unavailable local, healthy, unscarred, non-traumatized tissues for local flaps. As long as, there is possibility for the use of local cutaneous or fasciocutaneous flaps in the reconstruction of postburn elbow contracture, it would be a better option.The local flaps are aethetically superior to the graft , grow with age, one stage operation unlike the distant flaps , no need for postoperative prolonged splinting or physiotherapy and the donor site can be closed primarily in some cases of local fasciocutaneous flaps with minimal donor site morbidity.