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Year : 2010  |  Volume : 18  |  Issue : 1  |  Page : 51-56

Role of external fixation and distraction device in release of long standing post burns contractures in hand : A review of 24 cases

Department of Plastic Surgery, S.S.G. Hospital 8 Medical College, Baroda, Gujarat, India

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Post burn hand contractures are still a problem in everyday plastic surgery. Out of all conflicting reports in Literature regarding optimal treatment of these patients varies from simpler methods to more complex reconstruction. Use of external fixator and distractor device for management of burns is a relatively new concept. In our study, 24 patients and 86 fingers with long standing post burn hand contracture were treated with application of external fixator and distractor devices after it was seen that complete release was not possible intra-operatively. The age group range from three years to 46 years. Assessing the patient preoperatively and deciding after intra-operative assessment carried out the selection of patients. The common indications for its application were early exposure of tendons at PIP joint level, shortened neurovascular pedicle, stiff joints and recoil of PIP joints with K wire unable to maintain joint stability. Distraction was started as early as 1 Oth postoperative day to more commonly on 14 th-21" postoperative days and was continued up to 6-8 weeks as required. Patients were followed up for a period of up to 1 year to detect and treat early and late complications and it is concluded that external fixator and distraction devices are an excellent tool in the armamentarium of the surgeon to treat complex burn deformities of hand. The functional and aesthetic results of this simple procedure are excellent with minimal morbidity.

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