PROXIMAL INTERPHALANGEAL JOINT AUTOFUSIONS AFTER EXTENSIVE BURNS

Seven patients with third-degree burns of >70% of their body had autof usions of 19 proximal interphalangeal joints. In 13 of the joints ther e was fixed deformity of >60-degrees. In addition to these deformities , each of the patients had deformities due to bums in the axilla and e lbows bilaterally. There was only one independently functional hand an d in that hand no proximal interphalangeal joint deformity was >40-deg rees. Two patients were totally dependent because of either bilateral involvement or infectious complications of the burn itself. In four pa tients the hand was used as a helping hand to some extent. In each of these four the patient had a less involved other hand and had satisfac tory activity of daily living skills as a consequence. Early splinting or skeletal fixation of burned joints developing flexion positions mi ght have avoided autofusions in poor position.