Neck Burn Contracture



10.1055/b-0034-97732

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.


Description




  • 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.



Work-up



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.



Treatment



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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