Why contractures form
Healing burns contract as scar tissue matures over 6–18 months. Across a joint, this pulls the joint into a bent position: the chin toward the chest, the arm against the body, fingers into the palm. Children are especially affected because the scar doesn't grow with them.
Dr. Vikrant's own published study of post-burn contractures at a tertiary centre in western India looked at how often they occur, where, and in whom (research). Across burn centres, the neck, armpit (axilla), elbow and hand are among the most commonly affected sites.
Prevention
- Early grafting of deep burns reduces contracture risk.
- Splints hold joints in the stretched position, especially at night.
- Pressure garments worn 23 hours a day for 6–12 months.
- Physiotherapy and stretching daily.
- Silicone gel or sheets on the scars.
When to operate
| Situation | Timing |
|---|---|
| Eyelids can't close (risk to the eye) | Early, urgently |
| Mouth can't open enough to eat | Early |
| Severe hand contracture in a child | Early, to allow normal development |
| Neck, axilla, elbow contractures limiting function | Usually after scar maturity, 6–12 months |
| Cosmetic improvement | After full maturity |
Techniques
- Z-plasty and multiple Z-plasties for narrow bands, which lengthen the scar using nearby skin.
- Release and skin grafting for broad contractures: the scar is cut, the joint straightened, and the gap covered with a skin graft.
- Local or regional flaps where the graft would sit over tendons or joints, or where recurrence is likely.
- Tissue expansion to grow extra skin before replacing large scarred areas.
After surgery
Splints and pressure garments are needed again after release to stop the scar tightening back. Physiotherapy is essential.
See burn treatment and scar revision.
Last reviewed: 2026-10-11
This page is general information, not a diagnosis or a treatment plan. Results and recovery differ between patients. Prices are starting prices and are confirmed after examination.