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Patient case: Burn Contracture

Discussion

A 10-year-old boy is brought to the clinic by his parents due to limited movement in his right hand and wrist. The parents report that the child sustained a severe burn on his right forearm a year ago after accidentally spilling hot water on himself. While the initial burn healed over time, they noticed increasing stiffness and difficulty in using his hand over the past several months. He struggles to fully extend his fingers and wrist, and his grip strength has significantly weakened.

On physical examination, the boy’s right forearm and hand show extensive scar tissue from the previous burn, with noticeable tightening of the skin over the wrist joint. The wrist is flexed, and the fingers are partially curled. There is reduced range of motion and limited ability to extend the fingers or wrist fully. The diagnosis of a burn contracture is made.

The child is referred to an orthopedic surgeon and a physical therapist. Surgical release of the contracture is planned to restore function, followed by intensive rehabilitation to improve mobility and prevent future stiffness.

Questions
1. What caused the initial injury that led to the burn contracture?

A) Fire

B) Hot water spill

C) Electrical burn

D) Chemical burn

2. What is the primary symptom that the boy is experiencing now?

A) Swelling

B) Limited movement in his hand and wrist

C) Pain during movement

D) Redness and warmth over the burn site

3. What was the physical finding during the examination of the boy’s hand?

A) Complete range of motion

B) Scar tissue and tightening of the skin

C) Bruising and discoloration

D) No visible abnormalities

4. What is the planned treatment to address the burn contracture?

A) Medications to reduce inflammation

B) Surgical release of the contracture

C) Application of burn creams

D) Use of a wrist splint only

Reveal answers

Answers

1. B

2. B

3. B

4. B

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