Figure-of-8 sling for prevention of recurrent axillary contracture after release and skin grafting

Abstract

The axilla is a frequent site of adduction contracture after deep thermal injury, especially in burns in developing countries where the timely treatment of burns and the prevention of contracture are not possible for lack of appropriate services. Chronic contractures are difficult to treat, as large areas of wounds need to be covered with skin grafts or flaps. However, the most daunting aspect of adduction contracture is the maintenance of release after correction; this is often dealt with using long-term abduction splints, most of which are very uncomfortable. Our purpose here is to analyse our results with a simple figure-of-8 sling. A descriptive study was made covering a period of 10 years, comprising 40 cases of chronic extensive axillary contracture. All the cases were treated with simple release and skin grafting followed by a figure-of-8 sling. Preoperative limb abduction ranged from 0° to 80°; whereas, the postoperative range, at 1 year of follow-up, was from 140° to 180°. Hence, we conclude that the application of a figure-of-8 sling for axillary post-burn contractures is a safe, comfortable, easy and more compliant way of splintage with at least as reliable results as with other abduction splints.