BURN SURGERY

Managing Pediatric Arm Contractures in a
Low-Resource Setting

A case-based course on surgical planning and multi-level release of
pediatric upper extremity burn contractures.
New Free
  • -
  • -
  • 45–60 minutes
  • Shareable Certificate
  • Expert discussion

Course description 

This case-based lecture focuses on the assessment and management of pediatric multilevel upper extremity contractures following burn injury in low-resource settings. Using the case of an 18-month-old child from rural Nepal, the course explores early contracture formation, biopsychosocial risk factors, surgical planning principles, and the importance of complete multi-level release. Topics include grading scar severity based on functional impact, surgical decision-making across multiple joints (shoulder, elbow, wrist, hand), techniques for contracture release and defect coverage (skin grafts, dermal substitutes, local flaps, free tissue transfer), and the concept of cutaneous recruitment. The course also emphasizes postoperative rehabilitation, splinting protocols, family education, growth considerations, and strategies for long-term follow-up when access to care is limited.
Reviewed by SURGhub, February 2026

This course is provided by:

ReSurge International logo
  • Specialty: Surgery
  • Subspecialty: Burn Surgery, Pediatric Surgery, Trauma & Critical Care Surgery, Plastic & Reconstructive Surgery, Skin & Soft Tissues
  • Target audience:   Surgeons dealing with Burns and burn care.
  • Level:   Advanced
  • Language: English
SURGhub
SURGhub

This course is provided by:

ReSurge International logo

Learning objectives

  • Identify clinical findings that define multi-level upper extremity contractures in pediatric burn patients.
  • Assess contracture severity across multiple joints based on functional limitation rather than scar appearance alone.
  • Describe the principles of complete contracture release, including the need to release subdermal structures when indicated.
  • Select an appropriate reconstructive method (e.g., skin graft, dermal substitute, local tissue rearrangement) based on defect size and location after release.
  • Explain how proximal contractures can impair distal function through limitations in cutaneous recruitment.
  • Outline a basic postoperative rehabilitation plan, including splinting and caregiver-directed stretching.

Course structure 

Learn from global reconstructive surgery experts

Join 67,000+ health workers from 219 countries and territories learning critical skills from global experts on SURGhub.

Course instructors

Dr. Tam Pham

Dr. Pham is Professor of Surgery at the University of Washington School of Medicine. He has worked in burn care for over 20 years. He is passionate about burn education and dissemination for lower resource settings.
Dr Tam Pham

Dr. Tam Pham

Burn surgeon
Professor at University of Washington School of Medicine
Shankar Man Rai

Shankar Man Rai, MD

Reconstructive surgeon
Surgical leader in Nepal

Shankar Man Rai, MD

Shankar Man Rai, MD, is a reconstructive surgeon and surgical leader in Nepal dedicated to expanding access to burn and reconstructive care in resource-limited settings. He has played a central role in strengthening local surgical capacity, training providers, and advancing sustainable burn care services in Nepal.

David Kulber, MD, FACS

David Kulber, MD, FACS, is a Professor of Surgery at Cedars-Sinai Medical Center and the Keck School of Medicine of the University of Southern California. He is Director of Hand and Upper Extremity Surgery and has extensive experience in plastic, reconstructive, and hand surgery, with a strong commitment to surgical education, global outreach, and advancing reconstructive care through research and innovation.
David Kulber

David Kulber, MD, FACS

Plastic, reconstructive, and hand surgeon
Professor of Surgery at Cedars-Sinai Medical Center and Keck School of Medicine
Katie Osborn

Katie Osborn, RN, BSN, MSN, EdD

Burn nurse
Professor Emeritus of Nursing

Katie Osborn, RN, BSN, MSN, EdD

Katie Osborn, RN, BSN, MSN, EdD, is a Professor Emeritus of Nursing. Dr. Osborn’s area of expertise includes both critical care burn and general critical care nursing. Dr. Osborn volunteered on 29 medical missions in the developing world.

Dharshan Sivaraj

Dharshan Sivaraj is a medical student at Stanford University School of Medicine.
Dharshan Sivaraj

Dharshan Sivaraj

Medical student
Stanford University School of Medicine

What learners are saying

-
-, -
-
-, -
-
-, -

Ready to start learning?

Access this comprehensive course free of charge and learn from global experts.

This course is provided by

ReSurge International logo

ReSurge International

ReSurge International is a nonprofit humanitarian organization with over 55 years of experience providing reconstructive surgical care in developing countries. Our mission is to build, scale, and sustain reconstructive surgical capacity to provide life-changing care to those with the greatest need. We train and support local surgical teams across Africa, Asia, and Latin America to sustainably address gaps in surgical care.

Popular courses

Get the SURGhub app

Take your courses with you, and download content to learn offline.
  • Download on the App Store
  • Get it on Google Play
SURGhub