Physiotherapy Rehabilitation in Post-Burn Contracture after Skin Graft and Flap: A Case Report

Abstrak

Introduction: Burn injuries can lead to post-burn contractures and functional limitations, particularly in the upper extremities. Although surgical reconstruction using skin grafts and flaps restores tissue integrity, physiotherapy is essential to optimize functional recovery.

Objective: To evaluate the effects of physiotherapy rehabilitation on pain, muscle strength, and range of motion in a pediatric patient with post-burn contracture following skin graft and flap reconstruction.

Methods: This case report involved a 6-year-old child with post-burn contracture of the right upper extremity following split-thickness and full-thickness skin grafts and flap reconstruction. The patient received physiotherapy once weekly for three sessions over two weeks, including infrared therapy, scar massage, and therapeutic exercises. Outcomes were assessed pre- and post-intervention using the Numeric Rating Scale (NRS), Manual Muscle Testing (MMT), goniometer for range of motion (ROM), and Vancouver Scar Scale (VSS).

Results: Pressure pain decreased from NRS 3 to 1 (−66.7%), and movement pain from NRS 2 to 1 (−50%). Muscle strength improved from MMT grade 3 to 4. ROM showed modest improvements, including wrist extension (+2°) and elbow flexion (+5°), while VSS remained unchanged (score 10). No adverse events were reported.

Conclusion: Physiotherapy combining infrared therapy, scar massage, and exercise improved pain, strength, and joint mobility but showed limited short-term effects on scar characteristics. Early and sustained rehabilitation is essential to enhance functional outcomes in pediatric burn patients.