Treatment of Equinus Deformity Caused byBurn Scar Contracture in Childhood

Abstract

 We report a case of equinus deformity with Achilles tendon shortening caused by scar contracture as a result of extensive burn injury in childhood. We obtained good results by performing Achilles tendon lengthening 3 times during growth and covering the periarticular region with a free latissimus dorsi musculocutaneous flap.
 In burn scar contracture, unlike nerve palsy or congenital clubfoot, the ankle joint is covered with hard and thick scar tissue, healthy tissue available for reconstruction is limited, and in children, recontracture during growth is a problem.
 In this case, osteotomy of the lower leg was suggested by the orthopedic surgeon, but we selected Achilles tendon extension because it required release of the periarticular hard scar contracture. Shortening of the lower limbs became marked due to the high degree of contracture, requiring reoperation during growth.
 Scar contracture of the skin requires careful surgical selection in consideration of growth, and should be treated differently from common equinus deformity, especially in children.