Burns is a thermal injury which can be as small as a drop of water or large upto the extent that it can involve the whole body. In either circumstance, proper assessment of the injury and immediate treatment plays a vital role for healing. Not all patients are fortunate enough to receive proper treatment of their burn injury. We recently had one such 21 years old boy who could not receive the treatment of his burns and fell victim of post burn hand deformity.

This patient sustained burn injury due to the accidental immersion of his hand in boiling water when he was 5 years old. Due to some circumstances, he couldn’t receive the treatment and the burn wounds healed on their own. When burn injury happens across the joint surfaces, as in this case, it produces the variable degree of functional limitations to the concerned joint. Additionally, when the burn is sustained during pediatric age (childhood), the healed scars can produce functional problems with the growth of the child. These were the reasons for post-burn hand deformity in our patient. In the language of plastic surgery, this is called “post burn flexion contracture” which fixes the fingers in the flexed (bending) position and restricts them from getting extended (straight). This condition produces significant difficulties for the affected individual in carrying out day-to-day activities.

This patient was operated for surgical release of his multiple finger contractures and coverage of the resultant defect with his own skin harvested from the thigh.

This surgery is very meticulous and done under tourniquet control and with the aid of magnification so as to protect tiny nerves and blood vessels running on both sides of the fingers. After the surgery, his hand was wrapped in dressing and supported by a splint (plaster). The post-operative care has to be stringent and regular follow up with physiotherapy are integral components of recovery.

Aftercare and follow-ups were carried out as per the protocol and ultimately, we could offer him what he wanted: A functional hand with fingers which can flex (bend) and extend (straighten) fully. You can see the full function of hand achieved after the surgery in this video.