Home Print this page Email this page Users Online: 39
Home About us Editorial board Search Ahead of print Current issue Archives Submit article Instructions Subscribe Contacts Login 
Year : 2018  |  Volume : 26  |  Issue : 1  |  Page : 9-14

Reconstruction of postburn crippled hands: A study of functional outcome

1 Department of Plastic Surgery, Institute of Non Communicable Diseases and Government Royapettah Hospital, Chennai, Tamil Nadu, India
2 Department of Hand and Reconstructive Micro Surgery, Tamil Nadu Government Multi Super Speciality Hospital, Chennai, Tamil Nadu, India

Correspondence Address:
Prof. Narayanan Chandramouli Hariharan
V-1, Sri Mahalakshmi Enclave, 24, Gandhi Road, Gill Nagar, Chennai - 600 094, Tamil Nadu
Login to access the Email id

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijb.ijb_20_18

Rights and Permissions

Introduction: In postburn survivors, quality of life depends on the functional ability of one's hands. However, restoring useful function in crippled hands is a formidable challenge. Understandably in such cases, there are no standardized rules regarding the sequence of release, the type of skin cover, the duration of immobilization by K wires, and the intensity of hand therapy. Patients and Methods: We formulated a protocol and evaluated the outcome for cases of severe contractures with a total loss of hand function and distorted hand architecture. It is a cross-sectional study of 10 consecutive patients and 14 hands operated in our department from January 2014 to June 2017. The patients were operated in two stages. At the first stage, contractures of the wrist, dorsum, and thumb web space were released. Extension contractures of the fingers and thumb were also released. During the second stage, the contractures of the palm, volar aspect of the fingers, and web spaces were released. In both the stages, the fingers were maintained in released position for 3 weeks by K wires and the raw areas were covered with split skin graft/skin flap. Results: Patients were assessed for the improvement of hand function by the disabilities of the arm, shoulder and hand (DASH) scores of the 10 patients operated, four returned to the original employment/school. Four found meaningful employment. Conclusion: The aim in crippled hands is to restore useful function in the least number of stages rather than improving the range of movement in individual joints. Maintaining the release achieved by surgery with K wires, coupled with aggressive therapy, prevent the recurrence of the contractures.

Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)

 Article Access Statistics
    PDF Downloaded178    
    Comments [Add]    

Recommend this journal