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June 28, 2026
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Abstract

BACKGROUND. Post-burn scar contractures restrict joint mobility and are a leading indication for reconstructive surgery. Z-plasty and full-thickness skin grafting (FTSG) are both established release techniques, but comparative evidence on long-term recurrence and functional recovery is limited. We compared range-of-motion (ROM) gain and recurrence between them. METHODS. In this prospective comparative study, 62 patients with post-burn contractures of the axilla, elbow, neck and other sites were allocated by morphology to Z-plasty (n=32) or FTSG (n=30). Goniometric ROM was recorded pre-operatively and at 3, 6 and 12 months; recurrence was loss of corrected ROM or a tethering band requiring revision. RESULTS. Mean ROM gain was 72.5 degrees after Z-plasty versus 86.5 degrees after FTSG (p<0.001). Recurrence was 6.2 versus 13.3 percent (Fisher exact p=0.418) over a mean follow-up of 16.3 months. Complications and aesthetic outcomes were comparable, with donor-site morbidity confined to the graft group. Both techniques restored meaningful joint excursion, supporting a morphology-driven approach: Z-plasty for linear bands and FTSG for broad planar defects.

Keywords

Burn scar contracture Z-plasty Full-thickness skin graft Range of motion

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Copyright (c) 2026 Rabab Abbas Hasan

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