Functional Recovery After Surgical Treatment of Post-Burn Contractures: A Retrospective Cohort Study

Background: Surgical release of post-burn contractures aims to restore mobility and improve scar quality; however, the relationship between scar improvement and functional recovery remains incompletely understood, particularly in the hand. Methods: We performed a retrospective cohort study of 208 patients undergoing surgical correction of post-burn contractures (2021–2025) at a national referral center. Scar outcomes were assessed using the Vancouver Scar Scale (VSS). Functional outcomes were evaluated with joint-specific range-of-motion (ROM) measurements at 3, 6, and 12 months. For digital contractures, extension deficit was defined as ≥10° loss of active extension. Owing to non-normal distributions, data are presented as medians (IQR), and non-parametric tests were used. Results: VSS improved significantly across all domains (all p < 0.001). Median VSS remained stable between 3 and 6 months, followed by a marked decrease by 12 months. Functional recovery varied by region: major joints showed near-complete restoration of functional ROM, whereas extension deficit remained persistently prevalent, affecting 27.0% of patients at 3 months and 29.2% at 12 months. Full flexion was maintained in 88.8% of patients throughout follow-up. At the cohort level, flexion and extension demonstrated largely independent recovery trajectories. Conclusions: Surgical treatment improves scar characteristics; however, functional recovery—particularly extension in digital contractures—may remain incomplete. Combined assessment of scar characteristics and functional outcomes may provide a more comprehensive evaluation of postoperative recovery following contracture release.