Shoulder Total Adduction Contracture After Burns: Anatomy and Treatment with Quadrangular Local Subcutaneous Pedicle Flap

  • Viktor M. Grishkevich
  • Max Grishkevich


Contracted scars and skin grafts covering the shoulder joint flexion lateral and medial surfaces cause a total adduction contracture. Scars have a severe scar surface deficit, excluding use of the local flap techniques. Skin transplants in the axilla shrink and contracture recurs; the big flaps used present a traumatic and deforming procedure. To prevent skin transplants from shrinkage and contracture recurrence, we developed a new technique based on scar quadrangular axillary subcutaneous pedicle flap and skin transplants. Excellent outcomes have elevated the level of rehabilitation of burn patients with severe shoulder edge adduction contractures. The new surgical method and results of its implementation are presented in this chapter.


Total (severe) shoulder contracture Anatomy of contracture Scar surface deficit Quadrangular scar axillary flap 


  1. 1.
    Grishkevich VM. Shoulder adduction contracture after burns: anatomy and treatment with quadrangular local scar subcutaneous pedicle flap, a new approach. Burns. 2013;39:1423–9.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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