Botulinum Toxin A for Improving Lack of Ankle Dorsiflexion Range of Motion After Major Burns - a Retrospective Chart Review.

Abstract

OBJECTIVE\nTo review the effectiveness of Botulinum Toxin A (BTX-A) for treating the loss of maximum ankle dorsiflexion range of motion after burn injury DESIGN: Retrospective chart review SETTING: Large urban burn center PARTICIPANTS: 5 patients with major burn injury and loss of ankle dorsiflexion range while hospitalized INTERVENTION: BTX-A treatment in addition to standard care MAIN OUTCOME MEASURES: Maximum ankle dorsiflexion range of motion at time of treatment, 1 month and 3 months post treatment RESULTS: Patients (n = 5) were 3-51 years old, with a total burn area from 18-95% and time from injury to BTX-A injection (80-125 units) was 19-93 days. Ankle range at the time of injection was -10 to -50 degrees, and all patients had improved ankle range at 1 month post-injection (-30 to +10 degrees). At 3 months post injection, 3 subjects had neutral ranges of motion that were relatively improved compared to pre-injection ranges. Patients with additional complications or severe injury showed regression toward pre-injection maximum ankle dorsiflexion range of motion.\n\n\nCONCLUSION\nThis retrospective study examines BTX-A as a potential tool for treating ankle plantar flexion contractures post major burn injury after failed conservative treatment. Initial review shows some patients may benefit from these injections, but more systematically designed studies are required to assess effectiveness. If effective, further investigation will be needed to validate and standardize treatment protocols, establish dosing, and assess long-term effectiveness in those with burn injury or severe complications.