Inventi Impact: Surgery

Inventi:hcs/18443/15

Recurrence of Post Burn Contractures of the Elbow and Shoulder Joints: Experience from a Ugandan\nHospital

Background: Recurrence of post-burn contractures, following inadequate management of post-burn contractures\n(PBC), is under reported. It is associated with multiple operations and an increased cost to patients and their\nfamilies. The purpose of this study was to determine the frequency of recurrence of PBC of the shoulder and the\nelbow joint three months after surgical intervention and the associated risk- factors.\nMethods: This was a prospective cohort study conducted at CoRSU hospital from March 2012 to November 2014.\nAll patients with PBC of the elbow and/or shoulder joint who consented to be in the study and met the inclusion\ncriteria were enrolled. Data was collected using a pretested, coded questionnaire. A goniometer was used to\nmeasure the active range of motion of the involved joint. The measurements were recorded in degrees. The data\nwas analysed with STATA version 12.1.\nResults: 58 patients were enrolled consecutively in the study. There were 36 females and 22 males, with a female\nto male ratio of 1.6:1. The age range was 0.75ââ?¬â??45 years, with a median age of 5 years. The average age at the time\nof injury was 3.4 years. The most common cause of initial burn injury was scalding. The average number of joints\ninvolved per patient was two. There was a high incidence of recurrence of PBC (52 %) among the participants. The\nshoulder had the highest frequency of recurrence at 67 %. The elbow joint had a frequency of recurrence of 27 %.\nAll participants with both elbow and shoulder joint involvement had PBC recur. The risk factors for recurrence were\nflame burn (p = 0.007), duration of PBC of more than 1 year (p = 0.018), and incomplete release of the contracture\n(p = 0.002). The presence of keloids, hypertrophic scars, ulcers and the occurrence of complications at the\ncontracture site were not associated with recurrence of PBC.\nConclusion: Recurrence of PBC of the elbow and shoulder joint is a common problem. The risk factors should be\nkept in mind during management of PBC to reduce the recurrence rate.