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Post Burn Deformities

Even if in the initial phase of acute hand burn injury all treatment measures have been executed properly, post burn deformities still occur and are the most common cause of skin contracture in the hand. Post burn scarring and contractures affect the function as well as the aesthetic appearance of the hand and remain the most frustrating late complication of a hand burn. If contractures or scarring affect the dominant hand, as they do on most occasions, the vocation and thereby the economic status of the patient suffer. Proper management of these deformities is thus highly desirable.

A classification of post burn deformities has been proposed by Achauer.

A. Claw deformity

  • Complete
  • Incomplete

B. Palmar contracture

C. Web space deformity

  • Web space contracture
  • Adduction contracture
  • Syndactylism

D. Hypertrophic scar and contracture bands

E. Amputation

F. Nail bed

G. Elbow

  • Flexion contracture
  • Deep burn with extensive tissue loss
  • Heterotopic ossification

H. Axilla