Objectives: the upper extremity is involved in the majority of severe burns. In developing countries,where   treatment   is   often   delayed   or   inadequate,   burns   sequelae   remain   a   major   public   healthproblem.   Follow-up   is   problematic,   rehabilitation   service   is   non-existent   and,   therefore,   upperextremity   burns   cause   important   scar   contractures   with   severe   disability.   Moreover,   surgicalreconstruction after contractures release is challenging.
Methods. Case report: a 4-year-old baby sustained an extensive burn at upper extremities and trunkwhen she was 1. She was treated in a developing country. Burns sequelae resulted in severe scarcontractures. In 2019, she was referred to our Center, for scar release and surgical reconstruction.She presented a complete loss of right axilla, elbow, wrist and hand function with fingers fusetogether.Left upper extremity presented a severe elbow flexion and wrist extension with a claw deformity ofthe hand. Surgical planning included scar incisions, tenolysis, amputation of affected phalanx andresurfacing of soft tissue defects with local flaps, dermal substitutes and skin grafts. To maintainand   gradually   increase   the   range   of   motion,   intensive   physiotherapy   rehabilitation   startedimmediately and  continued at home, providing education to the  patient and her caregiver. Thepatient was hosted by a local voluntary association for the entire duration of treatments.
Results: we performed 12 surgical procedures from March 2019 to October 2021 for a total of sevenhospitalizations. We restored a complete elbow and wrist function at left upper extremity and weobtained a good functional pollicis-digital grip, key pinch and fingers flexion-extension range ofmotion. At right upper extremity we obtained a complete shoulder abduction and elbow flexion-extension range of motion. At the hand we obtained a limited but gradually improving functionalpollicis-digital grip.
Conclusion: reconstructive surgeons may follow different algorithms to achieve an efficient releaseof burn contractures. However, the final choice must always be personalized to the patient. Due to the age of our patient, we decided not to use free flaps to preserve donor site in a growing patient.With a complex reconstructive program, we obtained our target to return joints to a functional rangeof motion. We allowed the right hand, at least, to grasp some objects. Open critical point in thetreatment of these patients, coming from developing countries, despite a local reference, remains thepossibility to maintain a remote and continue follow-up

- Objectives: the upper extremity is involved in the majority of severe burns. In developing countries,where   treatment   is   often   delayed   or   inadequate,   burns   sequelae   remain   a   major   public   healthproblem.   Follow-up   is   problematic,   rehabilitation   service   is   non-existent   and,   therefore,   upperextremity   burns   cause   important   scar   contractures   with   severe   disability.   Moreover,   surgicalreconstruction after contractures release is challenging.
- Methods. Case report: a 4-year-old baby sustained an extensive burn at upper extremities and trunkwhen she was 1. She was treated in a developing country. Burns sequelae resulted in severe scarcontractures. In 2019, she was referred to our Center, for scar release and surgical reconstruction.She presented a complete loss of right axilla, elbow, wrist and hand function with fingers fusetogether.Left upper extremity presented a severe elbow flexion and wrist extension with a claw deformity ofthe hand. Surgical planning included scar incisions, tenolysis, amputation of affected phalanx andresurfacing of soft tissue defects with local flaps, dermal substitutes and skin grafts. To maintainand   gradually   increase   the   range   of   motion,   intensive   physiotherapy   rehabilitation   startedimmediately and  continued at home, providing education to the  patient and her caregiver. Thepatient was hosted by a local voluntary association for the entire duration of treatments.
- Results: we performed 12 surgical procedures from March 2019 to October 2021 for a total of sevenhospitalizations. We restored a complete elbow and wrist function at left upper extremity and weobtained a good functional pollicis-digital grip, key pinch and fingers flexion-extension range ofmotion. At right upper extremity we obtained a complete shoulder abduction and elbow flexion-extension range of motion. At the hand we obtained a limited but gradually improving functionalpollicis-digital grip.
- Conclusion: reconstructive surgeons may follow different algorithms to achieve an efficient releaseof burn contractures. However, the final choice must always be personalized to the patient. Due to the age of our patient, we decided not to use free flaps to preserve donor site in a growing patient.With a complex reconstructive program, we obtained our target to return joints to a functional rangeof motion. We allowed the right hand, at least, to grasp some objects. Open critical point in thetreatment of these patients, coming from developing countries, despite a local reference, remains thepossibility to maintain a remote and continue follow-up

P.129 Upper extremities reconstruction in a 4-year-old baby with complex post-burns scars

Dear friends and colleagues,

We will be pleased to welcome you in Turin (Italy) for the 19th European Burns Association´s Congress in 2022. Italy is honored to hold the meeting of the European Burns Association for the second time, after Verona in 1995. Turin is easily reachable from everywhere in Europe, either travelling by car, train or choosing flight connections. During the meeting, held in the renewed industrial center of the main Italian historical automotive factory (i.e. Lingotto-FIAT), we will meet international burn specialists, focusing on standards of care, progresses in burn treatment, strategies to face disaster situations, with a special attention to education of younger colleagues. However, in your spare time, you might enjoy the sweet days of Italian late summer, simply wandering in the green parks and gardens along the two rivers which cross the city, or you might decide to discover the numerous art galleries, churches, palaces, libraries, walking across elegant squares and large boulevards, passing through centuries of art and history; finally, you may choose to immerse yourself in some of the most exciting museum experiences, such as the Cinema Museum and the Turin’s Egyptian museum.

Looking forward to seeing you all in Turin for the 19th European Association´s Congress in 2022!
Maurizio Stella, Congress President, Turin Burn Centre