Anouk M Oosterwijk1, Leonora J Mouton2, Moniek Akkerman3, Matthea M Stoop4, Margriet E van Baar5, Sonja M H Scholten-Jaegers6, Cees P van der Schans7, Marianne K Nieuwenhuis8. 1. Hanze University Groningen, University of Applied Sciences, Research Group Healthy Ageing, Allied Health Care and Nursing, Petrus Driessenstraat 3, 9714 CA Groningen, The Netherlands; Association of Dutch Burn Centres, Burn Centre Groningen, Martini Hospital, Van Swietenplein 1, 9728 NT Groningen, The Netherlands; University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Hanzeplein 1, 9713 GZ Groningen, The Netherlands. Electronic address: a.m.oosterwijk@pl.hanze.nl. 2. University of Groningen, University Medical Center Groningen, Center for Human Movement Sciences, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands. Electronic address: l.j.mouton@umcg.nl. 3. Association of Dutch Burn Centres, Burn Centre Groningen, Martini Hospital, Van Swietenplein 1, 9728 NT Groningen, The Netherlands; University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Hanzeplein 1, 9713 GZ Groningen, The Netherlands. Electronic address: m.akkerman@mzh.nl. 4. Association of Dutch Burn Centres, Burn Centre Red Cross Hospital, Vondellaan 13, 1942 LE Beverwijk, The Netherlands. Electronic address: mstoop@rkz.nl. 5. Association of Dutch Burn Centres, Burn Centre, Maasstad Hospital, Maasstadweg 21, 3079 DZ Rotterdam, The Netherlands; Department of Public Health, Erasmus Medical Centre, Doctor Molewaterplein 40, 3015 GD Rotterdam, The Netherlands. Electronic address: baarm@maasstadziekenhuis.nl. 6. Association of Dutch Burn Centres, Burn Centre Groningen, Martini Hospital, Van Swietenplein 1, 9728 NT Groningen, The Netherlands. Electronic address: s.scholten@mzh.nl. 7. Hanze University Groningen, University of Applied Sciences, Research Group Healthy Ageing, Allied Health Care and Nursing, Petrus Driessenstraat 3, 9714 CA Groningen, The Netherlands; University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Hanzeplein 1, 9713 GZ Groningen, The Netherlands; University of Groningen, University Medical Center Groningen, Department of Health Psychology, Hanzeplein 1, 9713 GZ Groningen, The Netherlands. Electronic address: c.p.van.der.schans@pl.hanze.nl. 8. Association of Dutch Burn Centres, Burn Centre Groningen, Martini Hospital, Van Swietenplein 1, 9728 NT Groningen, The Netherlands; University of Groningen, University Medical Center Groningen, Center for Human Movement Sciences, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands. Electronic address: m.k.nieuwenhuis@mzh.nl.
Abstract
BACKGROUND: Scar contracture is a well-known sequela of burns that is specifically relevant as it may limit function. Reports regarding the course of scar contractures, however, are scarce and, moreover, not focussed on function. This study describes the course of prevalence of scar contractures that limit function in children and adolescents after burns. METHOD: Range of motion (ROM) of extremity joints of 20 children and adolescents after burns were assessed at discharge (T0) and at six weeks (T1), three months (T2), and six months (T3) after discharge. A scar contracture limiting function was defined as a measured ROM lower than the functional ROM, i.e., ROM used to perform daily activities by unimpaired subjects. RESULTS: At discharge (T0), 89.5% of the subjects had one or more scar contractures that limited function. Six months later (T3), this prevalence was 76.5%. At discharge (T0), less function limiting scar contractures were found for the upper extremity (29.7%) than the lower extremity (53.3%). Over time, prevalence of contractures in both extremities fluctuated between 22% and 35%. CONCLUSIONS: The majority of children and adolescents (13/17) still had scar contractures limiting function six months after discharge (T3). Substantial longitudinal studies over a longer period of time are needed to increase our knowledge on the course of these scar contractures in order to support improvements in burn care. TRIAL REGISTRATION: The study is approved by the Regional Committee for Patient-Oriented Research Leeuwarden in the Netherlands (NL45917.099.13).
BACKGROUND: Scar contracture is a well-known sequela of burns that is specifically relevant as it may limit function. Reports regarding the course of scar contractures, however, are scarce and, moreover, not focussed on function. This study describes the course of prevalence of scar contractures that limit function in children and adolescents after burns. METHOD: Range of motion (ROM) of extremity joints of 20 children and adolescents after burns were assessed at discharge (T0) and at six weeks (T1), three months (T2), and six months (T3) after discharge. A scar contracture limiting function was defined as a measured ROM lower than the functional ROM, i.e., ROM used to perform daily activities by unimpaired subjects. RESULTS: At discharge (T0), 89.5% of the subjects had one or more scar contractures that limited function. Six months later (T3), this prevalence was 76.5%. At discharge (T0), less function limiting scar contractures were found for the upper extremity (29.7%) than the lower extremity (53.3%). Over time, prevalence of contractures in both extremities fluctuated between 22% and 35%. CONCLUSIONS: The majority of children and adolescents (13/17) still had scar contractures limiting function six months after discharge (T3). Substantial longitudinal studies over a longer period of time are needed to increase our knowledge on the course of these scar contractures in order to support improvements in burn care. TRIAL REGISTRATION: The study is approved by the Regional Committee for Patient-Oriented Research Leeuwarden in the Netherlands (NL45917.099.13).