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

Table 1 General characteristics of the 5 cases

	Sex	Age (yr)	Cause of injury	Total body surface area (%)	Main body parts	Skin grafting	Rehabilitation issues
Case 1	Male	31	Flame	72	Hands	Split-thickness skin grafting	Hypertrophic burn scar, flexion deformity, narrowing of the first web space
Case 2	Male	2	Flame	2	Left hand	Split-thickness skin grafting	Hypertrophic burn scar, left syndactyly
Case 3	Male	6	Flame	Unknown	Face	No skin grafting	Hypertrophic burn scar of the jaw
Case 4	Male	3	Flame	Unknown	Right lower limb	Mesh grafting	Hypertrophic burn scar
Case 5	Male	11	Flame	71	Lower limbs	Skin grafting	Flexion contracture of bilateral popliteal fossa caused by scar contracture

Table 2 Main rehabilitation measures and the injuries of the patients

	Main rehabilitation measures	Main problems	New injuries	Remedies	Outcomes
Case 1 (Figure 1)	Compression therapy; Functional orthosis	Orthotic device was not adjusted properly	Significantly reduced first web space angle, thumb abduction and flexion contracture of metacarpophalangeal joint	Added an extension position orthosis that was alternated with a functional orthosis	Appearance and function of the hands were improved significantly
Case 2 (Figure 2)	Compression therapy, home rehabilitation, regular follow-up	Wrong wrapping method, excessive compression, not followed regularly	Syndactyly, hyperplasia, and hypertrophy of the distal soft tissue of the fingers on the left hand	Educated the parents about rehabilitation training, demonstrated correct wrapping methods, surgically corrected syndactyly, followed up regularly	The finger webs were evenly spaced, and the soft tissue hypertrophy of the little finger was alleviated
Case 3 (Figure 3)	Compression therapy with elastic headgear	Elastic headgear was worn too long, size was not adjusted in time; not followed regularly	Restricted development of alveolar bone; restricted mouth opening and occlusal dysfunction	Provided modified elastic headgear in time and optimized the wearing scheme; followed up every month	Restricted mouth opening was relieved; occlusal function returned to normal, and the facial appearance was significantly improved
Case 4 (Figure 4)	Compression therapy	Elastic bandage was applied with too much pressure for a long time	Limb muscle atrophy	Adjusted the compression intensity of the elastic bandage, strengthened functional exercise of the affected limb, performed massage and kerotherapy to promote blood circulation	Deformity of the lower leg was improved slightly
Case 5 (Figure 5)	Functional exercise, antiscar treatment	Violent correction of lower limb flexion deformity	Femoral fracture	Immobilized the affected limb with a plaster cast	The fracture gradually healed

Table 3 The status of the patient at the follow-up visit at 5 year after the burn

Body part	Left circumference (the injured side, cm)	Right circumference (cm)
Ankle joint	20	19
Thickest part of the calf	20	25
10 cm below the knee	21.2	21
Thickest part of the thigh	30	33
Leg length	65.5	67