Assessment of functional outcomes in burned children after axillary contracture release.

摘要

INTRODUCTION: Children with severe axillary burns frequently require surgical release of scar contractures to restore "normal" motion. Data on functional outcomes after this procedure is lacking. Our hypothesis is that children use compensatory motion patterns to accomplish functional tasks after axillary contracture formation and that successful contracture release normalizes those patterns. METHODS: The functional movement of twelve children >/=5 years of age who underwent surgical axillary contracture release was studied prospectively prior to and 1 year after surgery. Movement of shoulder, neck, trunk, and arm were analyzed during five functional tasks: high reach, hand to head, hand to back pocket, receiving change, and waving. Patient motion was recorded, and 3D motion analyzed utilizing a previously validated computer model. RESULTS: Twelve children, mean age of 8.4 years, completed the study. Functional shoulder and trunk range of motion are depicted in the table below. Mean angular position indegrees with standard deviation is shown for burn patients pre and post release. Positive angular excursions represent joint motions of flexion, abduction, or external rotation. Negative angular excursions represent joint motions of extension, adduction, or internal rotation. CONCLUSIONS: Surgical correction of axillary contractures in children result in marked changes in movement patterns during functional tasks. Surgical release of the contracture results in significant normalization of movement and improves patient functional outcomes.