Postburn Knee Flexions Contractures: Anatomy and Methods of Their Treatment

Knee postburn scar flexion contractures, making up 22% of large joint contractures [1], affect the leg motion, impair the lower extremity function, present cosmetic defects, and requiring surgical treatment. The contracted scars undergo (during joint extension) severe tension, tearing, and often are converted to pathologic scars-rough, thick, solid, prone to keloid growth and ulceration. Review of literature shows that there is less research on knee scar flexion contractures, than on the large joints of upper extremities, when it comes to surgical treatment. There is no existing anatomical classification of flexion contractures that could serve as a guide, for reconstructive technique choice, which presents a clinical challenge [2]. Many surgical techniques have been described; however, an ideal method is yet to be found [3]. The most common treatment methods are based on the incisional contracture release and skin grafting or on the local triangular flap techniques [4]. Rarely, regional pedicled or free flaps and Ilizarov fixator are used. Most of these methods were tested in our institute; a high rate of complications and contracture recurrence induced us to search for a more efficient approach.