Surgical Options For Axillary Contractures

Abstract

Background: The axilla is one of the most frequently affected areas by post burn contractures with associated cosmetic and functional problems. A variety of therapeutic options exist but when this is not properly chosen or post operative rehabilitation is not properly adhered to, recurrence is often seen. The aim of this paper is to highlight the various management options used in managing these problems in a burn unit and itemize complications commonly encountered. Materials And Methods: This is a retrospective review of cases of axillary contractures managed at the National Orthopaedic Hospital over a period of 5 years. The sources of information were the operation registers and the case notes of the patients. Information obtained include age, sex, part of the axilla involved, other associated post burn problems, option(s) of treatment, complications and results. Results: A total of 37 patients presented with axillary contractures involving 42 axillae. Their ages range between 2 and 47 years with a mean of 23.1 years. There were 20 males and 17 females. Surgical options used includes local fasciocutaneous flaps, 18(42.8%)axillae, single z-plasty in 6 (14.3%) axillae, split thickness skin graft in 6(14.3%) axillae, multiple z-plasty in 3(7.1%)and myocutaneous flaps including latismus dorsi in 5(11.9%), double opposing z-plasty in 2(4.8%) while v-y plasty and 5-flaps z-plasty were used in 1(2.4%) each.