Treatment of Axillary Burns
Study
Main
Research
Purpose
Design
Sample
Outcome
Measures
Results
Study
Level of
Category Evidence
Abhyankar,
200196
7 subjects with
axillary burns
Clinical outcome
Not described in detail,
no complications
reported with the use of
the splint
Therapeutic
IV
Both groups had
Therapeutic
improved abduction and
flexion compared to preoperative ROM
IV
The authors state that
Therapeutic
the splint is simple to
apply and adjust to fit the
patient.
Before surgery the mean Therapeutic
abduction was 50
degrees and median
was 45 degrees. At the
time of surgery the
maximum mean
shoulder abduction was
164 degrees and median
170 degrees. At 1 year
follow-up, mean was 154
degrees and median 165
degrees.
IV
Description of
a splint to treat
axillary
contractures.
Greenhalgh, Evaluate the
199398
efficacy of
early axillary
releases of
contracture,
completed
before scar
maturation.
Case series of
subjects treated with a
splint with straps to
maintain the arm
position in abduction.
Retrospective Case
series.
Manigandan Description of
200397
a splint for
axillary burns.
Descriptive
37 patients who
Range of motion
had axillary
after surgery.
release >1 year
after injury and 10
patients who had
axillary release < 1
year after injury.
The average
TBSA was 41%.
Subjects > 1 year
post-injury had
worse pre-op scar
contractures.
None
None
Obaidullah,
200595
Retrospective case
series of patients
treated with splint for 3
months after axillary
contracture release.
45 subjects who
had surgical
release of an
axillary
contracture.
Description of
the use of a
figure of 8
splint after
axillary
contracture
release.
Range of motion
IV
Palmieri,
200394
Description of
alterations in
shoulder
movement
during
activities of
daily living in
children with
axillary
contractures.
Prospective study of
children scheduled for
axillary contracture
surgical release.
Kinematic analysis
during a high reach
task and a hand to
back pocket task.
11 children with
axillary
contracturesand
49 age matched
controls
Kinematic analysis
Tanaka,
200399
Evaluation of
functional
improvement
after surgical
release of
axillary
contracture
Case series
13 patients with
Range of motion
severe axillary
burn scar
contracture. Preoperative
restriction in
shoulder abduction
was 30-90
degrees.
Contracture
treated primarily
with flap procedure
with Z-plasty in 4
cases and skin
graft in one case.
In high reach task
Prognostic
subjects with burns had
a significant loss of
shoulder flexion,
shoulder internal
rotation, compensatory
trunk extension, forearm
pronation and had an
increase in elbow
flexion. Shoulder
abduction was not
affected. In the hand to
back pocket task there
was a decrease in
shoulder extension and
elbow flexion with an
increase in shoulder
abduction.
In 12 cases the postTherapeutic
operative shoulder
abduction was 170-180
degrees. In one case
the pre-operative
abduction was 30
degrees and improved
only to 90 degrees.
III
IV