Post-burn axillary contracture: A therapeutic challenge!

Karki, Durga; Mehta, Nikhil; Narayan, Ravi Prakash

doi:10.4103/0970-0358.146594

Cited by 21 publications

(23 citation statements)

References 9 publications

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“…21 The axillary wound in postmastectomy patients, irradiation injuries, or failed musculocutaneous flap repair requires adequate flap coverage to preserve the axillary vessels and brachial plexus. 22 SH of BB muscle flap can be used to cover the axillary as well as upper arm defects in cases of elbow arthrodesis. 23 The cases with SH of BB may be an added advantage in upgrading the procedure without jeopardizing the function of the upper limb.…”

Section: Discussionmentioning

confidence: 99%

Morphological variations of biceps brachii muscle in eastern indian population: A cadaveric study

et al. 2020

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Background and Aims Biceps brachii (BB) is the commonest muscle in the upper limb showing variations. Supernumerary heads of biceps brachii have been frequently reported in literature. The aim of the present study is to report the occurrence and detailed anatomy of the supernumerary heads of biceps brachii, including its nerve supply among the Eastern Indian population. Materials and Methods A total of 50 upper limbs (25 right and 25 left upper limbs) of embalmed cadavers were dissected and examined for the variation in the origin of BB. Observations Out of 50 upper limbs, five upper limbs (10%) showed supernumerary heads of BB. Inferomedial humeral type of supernumerary head was predominant. A significant percentage (80%) of the supernumerary heads were associated with the nervous variation. Conclusion Biceps muscle is well-known for variation in its origin. Anomalous muscle tear may present as shoulder pain in these patients, magnetic resonance imaging (MRI) may be diagnostic. Detailed anatomy of supernumerary heads serves as a potential tool for graft or flap surgeries with preservation of the function of superior extremities. The awareness of supernumerary heads of biceps brachii in relation to adjacent neurovascular bundles is necessary for modern-day imaging techniques and surgeries.

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Section: Discussionmentioning

confidence: 99%

Morphological variations of biceps brachii muscle in eastern indian population: A cadaveric study

et al. 2020

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“…Numerous local and distant flaps have been employed, such as V–Y and Z-plasty techniques for linear band contractures, local fasciocutaneous flaps that may or may not include previously burned skin territories, radial, ulnar and posterior interosseous fasciocutaneous proximally-based flaps and reversed flow flaps such as the lateral arm and the ulnar recurrent upper-arm flap. [ 3 4 ] In addition, distant pedicle and microvascular transfer flaps are also being used. In all these flaps, the functional losses, cosmetic results and compromise of future reconstructive options should be taken into consideration while planning these surgeries.…”

Section: Discussionmentioning

confidence: 99%

Subcutaneous pedicle propeller flap: An old technique revisited and modified!

Karki

Mehta

Narayan

2016

Indian J Plast Surg

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Background:Post-burn axillary and elbow scar contracture is a challenging problem to the reconstructive surgeon owing to the wide range of abduction and extension that should be achieved, respectively, while treating either of the joint. The aim of this paper is to highlight the use of subcutaneous pedicle propeller flap for the management of post-burn axillary and elbow contractures.Methodology:This is a prospective case study of axillary and elbow contractures managed at a tertiary care hospital using propeller flap based on subcutaneous pedicle from 2009 to 2014. Surgical treatment comprised of subcutaneous-based pedicle propeller flap from the normal tissue within the contracture based on central axis pedicle. The flap was rotated axially to break the contracture. The technique further encompassed a modification, a Zig-Zag incision of the flap, which was seen to prevent hypertrophy along the incision line. There was a mean period of 12 months of follow-up.Results:Thirty-eight patients consisting of 22 males and 16 females were included in this study among which 23 patients had Type II axillary contractures and 15 had moderate flexion contractures at elbow joint. The post-operative abduction achieved at shoulder joint had a mean of 168° whereas extension achieved at elbow had a mean of 175°. The functional and aesthetic results were satisfactory.Conclusion:The choice of surgical procedure for reconstruction of post-burn upper extremity contractures should be made according to the pattern of scar contracture and the state of surrounding skin. The choice of subcutaneous pedicle propeller flap should be emphasised because of the superior functional results of flap as well as ease to learn it. Moreover, the modification of propeller flap described achieves better results in terms of scar healing. There is an inter-positioning of healthy skin in between the graft, so it prevents scar band formation all around the flap.

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“…O altă problemă este cea a dezvoltării cicatricilor retractile (limitante), care odată cu trecerea timpului au tendinţa să fixeze glanda mamară la structurile învecinate, linia axilară anterioară fiind în acest sens principalul reper anatomic implicat. Cicatricile retractile localizate la acest nivel au tendinţa de a limita mişcarea braţului prin ancorarea regiunii axilare şi mamare (7).…”

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The treatment of post-burn breast scars

Bejinariu¹,

Apostolescu²,

Marinescu³

2019

Ro J Med Pract.

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RezumatLucrarea de faţă prezintă cazul unei paciente în varstă de 36 de ani care a fost victima unei deflagraţii la 8 ani, traumatismul soldându-se cu arsuri de gradul IIb -III la nivelul membrelor superioare, toracelui şi regiunii abdominale. În urma evaluării clinice protocolul terapeutic a fost elaborat pentru rezolvarea considerentelor de tip funcţional şi estetic. Recuperarea mobilităţii membrului superior drept, întreruperea continuităţii cicatricei retractile implicând regiunile brahială, axilară şi mamară, precum şi crearea premiselor locale pentru facilitarea expandării mamare în vederea reconstrucţiei sânului au reprezentat principalele obiective ale tratamentului reconstructiv. Evoluţia cicatricilor postcombustionale survenite în copilărie, reclama efectuarea unor intervenţii chirurgicale etapizate, pentru crearea condiţiilor optime de dezvoltare a structurilor anatomice afectate. AbstractThis paper presents the case of a 36-year-old patient who has been the victim of a deflagration when she was 8 years old, suffering from IIb -III degree burns affecting the upper limbs, thorax and abdominal region. Following clinical evaluation, the therapeutic protocol was developed to address functional and aesthetic considerations. Recovering the right upper leg mobility, discontinuing the retraction of the scar, involving the brachial, axillary and mammary regions, as well as creating local premises in order to facilitate breast tissue expansion before breast reconstruction were the main objectives of reconstructive treatment. The evolution of the burn scars from her childhood requires staged surgical interventions while aiming to create optimal conditions for the development of the affected anatomical structures.

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Post-burn axillary contracture: A therapeutic challenge!

Cited by 21 publications

References 9 publications

Morphological variations of biceps brachii muscle in eastern indian population: A cadaveric study

Morphological variations of biceps brachii muscle in eastern indian population: A cadaveric study

Subcutaneous pedicle propeller flap: An old technique revisited and modified!

The treatment of post-burn breast scars

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