Neck Burn Contracture
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.
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
Establish improved range of motion and release significant contractures.
Restriction of movement may affect skeletal maturation and speech.
Consider sliding genioplasty (when skeletally mature).
Chest and breast contractures