Hoffer M, Lankenau J, Wellisz T
Department of Surgery, Rancho Los Amigos Medical Center, Downey, California.
J Orthop Trauma. 1994;8(3):249-51. doi: 10.1097/00005131-199406000-00012.
Seven patients with third-degree burns of > 70% of their body had autofusions of 19 proximal interphalangeal joints. In 13 of the joints there was fixed deformity of > 60 degrees. In addition to these deformities, each of the patients had deformities due to burns in the axilla and elbows bilaterally. There was only one independently functional hand and in that hand no proximal interphalangeal joint deformity was > 40 degrees. Two patients were totally dependent because of either bilateral involvement or infectious complications of the burn itself. In four patients the hand was used as a helping hand to some extent. In each of these four the patient had a less involved other hand and had satisfactory activity of daily living skills as a consequence. Early splinting or skeletal fixation of burned joints developing flexion positions might have avoided autofusions in poor position.
