Secondary injuries caused by ill-suited rehabilitation treatments: Five case reports

Figure 1 Treatment with an improper brace led to secondary deformity and malfunction of both hands. A: Simple fixation in a functional position in the early stage; B: Reduced thumb abduction and flexion; contracture of the metacarpophalangeal joint; C: Alternating use of 2 orthotic devices in functional and straight positions; D: At 4 mo after treatment, flexion of the metacarpophalangeal joint, first web space contracture, and thumb abduction all improved significantly.

Figure 2 Improper rehabilitation at home led to distal deformities of the fingers. A: Four days after the burn; B: At 7 mo after the burn, syndactyly of the third and fourth fingers and abnormal growth of the distal soft tissue of multiple fingers were observed; C: At 8 mo after the burn (1 mo after syndactyly repair), syndactyly was corrected, and distal soft tissue deformity of multiple fingers was alleviated; D: At eleven months after the burn (3 mo after syndactyly repair) (left) and at 14 mo after the burn (6 mo after syndactyly repair) (right), the above deformities had obviously improved.

Figure 3 Abnormal mandibular development due to improper compression therapy occurred because regular follow-up was not adhered to as suggested. A: Three years after the burn injury; B: After 2 year of compression therapy using elastic headgear and before scalp tissue expansion (5 year after the burn); C: Scalp tissue expansion following 2 year of compression therapy using elastic headgear (5 year after the burn); D: Two years after regular follow-up and regular adjustment of the headgear for compression therapy (7 year after the burn).

Figure 4 Improper home rehabilitation treatment led to severe dystrophy of the affected limb. A: During the burn wound repair period; B: Seven months after the burn; C: Nine months (left) and 18 mo (right) after the burn; D: Five years after the burn.

Figure 5 Fracture by ill-suited burn rehabilitation. A: Large-area burns on the body of the child on admission on January 12, 2016; B: Right femoral fracture on August 1, 2016 (B1); 10 d after plaster immobilization (B2); the fracture was almost healed 1 mo after immobilization (B3); C: Scars on September 7, 2016.

Figure 6 Three-level burn rehabilitation treatment system. Consolidation rehabilitation: Repetitive rehabilitation therapy without a new treatment program; Intensive rehabilitation: The addition of new treatment approaches or the modification and adjustment of treatment approaches for some conditions; Comprehensive rehabilitation: Professional burn rehabilitation and general rehabilitation treatment. Surgical treatment includes surgical correction or functional reconstruction.