Quality of Life After Burn Injury: The Impact of Joint Contracture Berrin Leblebici, MD,* Mehmet Adam, MD,* Selda Bag ˘is ¸, MD,* Akin M. Tarim, MD,† Turgut Noyan, MD,† Mahmut N. Akman, MD,* Mehmet A. Haberal, MD, FACS, FICS (Hon)† We sought to investigate quality of life, and to specifically assess how joint contracture af- fects it, in patients with burn injuries. The study is involved 22 adults with burn injuries. Patients were divided into two groups according to the presence (n  11) or absence (n  11) of any joint contracture. Patient age, sex, date of burn injury, burn type, location, and extent of burn (TBSA) were recorded for each case. Each individual underwent a thorough musculoskeletal system examination, with special focus on range of motion of the joints. Quality of life was evaluated using the Short Form 36 (SF-36). Eight (36.4%) of the pa- tients were women, and 14 (63.6%) were men, and their mean age ( SE) was 24.7  4.68 years. The mean interval from injury to the study assessment was 21.45  14.69 months. Eleven patients (50%) had at least one joint contracture. The patients with one or more contractures had significantly lower scores for the SF-36 subscales of physical functioning, physical role limitations, bodily pain, and vitality (P  .05, P  .01, P  .04, and P  .02, respectively). In the 22 patients overall, TBSA was negatively correlated with the scores for the SF-36 subscales vitality and emotional role limitations (r .586 and r .805, respectively). Joint contracture does impact burn patients’ quality of life, especially with respect to physical functioning, physical role limitations, bodily pain, and vitality. In addition, the amount of BSA burned is correlated with psychosocial problems and poorer quality of life, regardless of whether joint contractures develop. (J Burn Care Res 2006;27:864–868) Key Words: Burn; Quality of Life; Contracture Fire disasters and burn injuries are important social problems in both developing countries and in highly industrialized countries. Burn injuries cause complex lo- cal and systemic responses that alter local microcircula- tion and metabolism, as well as cardiovascular, endo- crine, and immune function. These are major changes that can lead to increased mortality and morbidity. 1,2 Burns can affect bone and joint structures. In chil- dren, such injuries can cause early epiphysial closure, which results in short extremities. 3 In adults, joint contracture, heterotrophic ossification, surgical scars, and esthetic problems are common after burns. Pos- tural abnormalities, such as scoliosis or kyphosis, may also develop. Septic arthritis and joint subluxation or dislocation can occur after serious burns at any age. 3,4 Joint contracture is defined as an inability to per- form full range of motion (ROM) of a joint and it is a common complication of burn injury. Burn-related contractures occur secondary to the protraction of granulation tissue overlying a joint surface or the skin near a joint. In addition, patients tend to keep their burned extremity in flexed and adducted position to relieve their pain, which facilitates shortening of soft tissues. 1 Dobbs and Curreri 5 and Kowalske et al 6 re- ported the prevalence of joint contracture as 28% and 42%, respectively. Advances in burn care during the last 30 years have reduced mortality rates in this patient group, and the focus of outcome assessment has shifted from mor- tality to morbidity in terms of deficits in functionality and quality of life. 7 Evaluation of quality of life is important for burn survivors, particularly those with massive burns. For these patients, planning of recon- From the *Departments of Physical Medicine and Rehabilitation and †General Surgery, Baskent University Faculty of Medicine, Ankara, Turkey. Address correspondence to Mehmet Haberal, MD, FACS, FICS (Hon), Faculty of Medicine, Baskent University, Ankara, Turkey. Copyright © 2006 by the American Burn Association. 1559-047X/2006 DOI: 10.1097/01.BCR.0000245652.26648.36 864