Neck Burn Contracture


Neck Burn Contracture

Gwendolyn Hoben & Albert S. Woo
A 14-year-old girl with a history of burns from a house fire several years prior enters with difficulty moving her neck.


  • Extensive burn contracture involving the neck, breasts, and anterior trunk

    • Evidence of previous split-thickness grafts to the neck.

    • Multiple tethering bands.

    • Limitation in neck rotation: ~ 50 degrees of lateral rotation.

    • Limitation in extension: 30 degrees of cervical superior extension.


History and physical examination

  • Mechanism, depth, and extent of previous burns.

  • Time interval since injury and reconstruction performed.

  • History of drooling, difficulty eating, speech deficiencies.

  • Identify contracture bands.

  • Assess for donor-site availability.

  • Medical comorbidities.

Pertinent imaging or diagnostic studies

  • Mandible series: Assess for mental (chin) retrusion.

  • Preoperative anesthesia assessment: May be an airway challenge given reduced extension.


Surgical planning of involved areas

  • Neck contracture

    • Establish improved range of motion and release significant contractures.

    • Restriction of movement may affect skeletal maturation and speech.

  • Mental retrusion

    • Consider sliding genioplasty (when skeletally mature).

  • Chest and breast contractures

    • Breast reconstruction options (see Cases 26 and 27) may be considered (upon skeletal maturity or if significantly affecting development of the breast).

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Jun 18, 2020 | Posted by in General Surgery | Comments Off on Neck Burn Contracture
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