Edge Shoulder Adduction Contracture in Pediatric Patients: Anatomy and Treatment

Abstract

Shoulder adduction contractures in children restrict upper limb motion, which delays joint development and curves the shoulder bone and spine; therefore, a surgical reconstruction should be performed as soon as contracture forms. Scars on the chest wall in children are prone to excessive abnormal growth and can severely disturb the child and parents. Most edge axillary contractures are treated with techniques based on triangular flaps (Z-plasty and their modifications and combination), but few articles have been devoted to follow-up outcomes. Triangular-flap techniques have many known disadvantages; skin transplants are prone to shrinkage, and regional pedicle flap use is traumatic for pediatric patients. In pediatric patients, edge shoulder anterior contracture and scar deformity of the shoulder joint anterior surface are fully eliminated with the use of the whole axillary adipose-cutaneous flap.