Journal of Burn Care And Research (formerly Journal of Burn Care & Rehabilitation)
Year, Volume, Issue, Page(s):, 38, 1, e192-e199
Study examines the incidence and severity of contractures in a large, multicenter, pediatric burn population and determined the associated risk factors for the development of contractures. Data from the National Institute on Disability and Rehabilitation Research Burn Model System database, for pediatric (younger than 18 years) burn survivors from 1994 to 2003, were analyzed. Demographic and medical data were collected on each subject. The primary outcome measures included the presence of contractures, number of contractures per patient, and severity of contractures at each of nine locations (shoulder, elbow, hip, knee, ankle, wrist, neck, lumbar, and thoracic) at time of hospital discharge. Regression analysis was performed to determine predictors of the presence, severity, and numbers of contractures. Of the 1,031 study patients, 237 (23 percent) developed at least 1 contracture at hospital discharge. Among those with at least one contracture, the mean was 3 contractures per person. The shoulder was the most frequently contracted joint (27.9 percent), followed by the elbow (17.6 percent), wrist (14.2 percent), knee (13.3 percent), and ankle (11.9 percent). Most contractures were mild (38.5 percent) or moderate (36.3 percent) in severity. The statistically significant predictors of contracture development were age and intensive care unit (ICU) length of stay. The statistically significant predictors of severity of contracture were age, ICU length of stay, presence of amputation, and black race. Predictors of the number of contractures included total age, length of stay, length of ICU stay, presence of amputation, total body surface area (TBSA) burned, and TBSA grafted.
Goverman, Jeremy, Mathews, Katie, Goldstein, Richard, Holavanahalli, Radha, Kowalske, Karen, Esselman, Peter, Gibran, Nicole, Suman, Oscar, Herndon, David, Ryan, Colleen M., Schneider, Jeffrey C.