Shoulder Medial Adduction Contracture: Anatomy and Treatment with Local Adipose Scar Trapezoid Flaps

  • Viktor M. Grishkevich
  • Max Grishkevich


Medial shoulder adduction contracture is a result of burns and scars of the axillary fossa, the joint flexion medial (FM) surface, and the inner surface of the shoulder and truncal lateral surface. Scars undergo repeat injury with shoulder abduction, and this stimulates connective scar tissue to grow. Therefore, scars of the axilla, growing distally and contracting, cause smoothing of the axillary fossa, pull axilla down, and form a crescent fold, where the crest passes along the medial line of axilla. The shoulder medial contracture is an unknown form of scar contracture, not included in existing classifications, and reconstructive techniques for its elimination have not yet been developed. Our broad experience has shown that medial scar contractures represent 8–10% of all axillary contractures. In this chapter we present all aspects of shoulder medial contractures from formation to treatment.


Shoulder medial contracture Shoulder contracture Contracture anatomy Contracture cause Shoulder contracture treatment Trapezoid flaps Trapeze-flap plasty 


  1. 1.
    Schneider JC, Holavanahalli R, Helm P, Goldstein R, Kowalske K. Contractures in burn injury: defining the problem. J Burn Care Res. 2006;27(4):508–14.CrossRefPubMedGoogle Scholar
  2. 2.
    Grishkevich VM. Postburn shoulder medial-adduction contracture: anatomy and treatment with trapeze-flap plasty. Burns. 2013;39:341–8.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Viktor M. Grishkevich
    • 1
  • Max Grishkevich
    • 2
  1. 1.Happy ValleyUSA
  2. 2.VIP MediSpaClackamasUSA

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