Custom-made cervical orthosis for pediatric neck scar contracture: a self-controlled case series

Post-burn cervical scar contracture causes functional and aesthetic impairments, significantly impacting pediatric patients. This study was designed as a self-controlled case series without a parallel control group, including 11 pediatric patients with cervical scar contractures who received treatment with a Custom-Made Cervical Orthosis. Pre- and post-treatment data were collected for the cervicomental angle (CMA), cervical range of motion (ROM), and other clinical symptoms, and paired analysis was conducted. Additionally, treatment satisfaction and long-term scar quality were assessed. After an average of 13 ± 5 months of treatment, the CMA significantly decreased from a median of 140°(interquartile range [IQR]: 130°–155°) before treatment to 120° (IQR: 115°–120°) after treatment (p < 0.001), representing a 16.6% reduction. Significant improvements in cervical ROM were observed in all five directions (p < 0.001). Clinical symptoms, such as inability to close the mouth and facial organ displacement, showed significant improvement (p < 0.05). At the final follow-up, the median POSAS score for long-term scar quality was 19 (IQR: 14–21). These findings from a small case series provide preliminary evidence that custom-made cervical orthoses provide significant anatomical and functional benefits by effectively repositioning cervicomental structures. By facilitating stable, long-term tissue remodeling, this non-surgical approach holds the potential to spare the majority of children with cervical contractures from undergoing further reconstructive procedures.