Abstract
BACKGROUND: Long-standing burn contractures of limb joints are resistant to complete surgical release and have been addressed earlier by serial casting, and more recently, distraction with a distractor, mostly limited to small joints of the hand. This retrospective study of patients with long-standing burn contracture was done to evaluate the efficacy of external skeletal distractors in securing complete release of various affected joints. MATERIALS AND METHODS: In our series, complete release was achieved through gradual manual distraction using skeletal uni- and multiplanar frameworks across the affected limbs after incisional release. The resultant wound after complete release was skin grafted or covered with flaps. RESULTS: Thirty-one limbs in 27 young patients (average age: 19 years) with long-standing contractures (18.5 years) due to burns underwent manual soft tissue distraction in order to achieve complete release (50-95 degrees across various joints). All patients achieved complete release of contractures with minimal complications. CONCLUSION: Gradual manual soft tissue distraction through external skeletal distractors of restricting soft tissue ("stretch as you go") after incisional release in long-standing burn contracture of limb joints achieves complete release without exposure of vital structures.