Outcomes After Deep Full-Thickness Hand Burns

Abstract 

Holavanahalli RK, Helm PA, Gorman AR, Kowalske KJ. Outcomes after deep full-thickness hand burns.

Objective

To measure hand-specific functional performance after deep full-thickness dorsal hand burns.

Design

Descriptive, cross-sectional study.

Setting

The 2005 Phoenix Society’s World Burn Congress, Baltimore, MD.

Participants

Volunteer sample of burn survivors (N=32) with full-thickness dorsal hand burns with extensor mechanism involvement, who consented to participate.

Interventions

Not applicable.

Main Outcome Measures

Total active motion of joints, Jebsen-Taylor Hand Function Test (JTHFT), and Michigan Hand Questionnaire (MHQ).

Results

Subjects had large burns (mean percentage total body surface area, 58%). Digit involvement was severe, with more than 50% having amputations and 22% with a boutonnière deformity. Forty percent of subjects had poor functional range with total active motion of less than 180°. Scores on the JTHFT were lower than normative scores, and subjects reported most difficulty in performing MHQ activities of daily living (ADLs).

Conclusions

Even with partial amputation or loss of extensor mechanisms, the intact flexor muscles facilitate function by allowing for a modified grasp and enable patients to be independent in most ADL tasks. Training programs can be developed to meet specific goals despite residual hand deformities caused by deep full-thickness burns.

Key Words: Burns, Hand, Hand deformities, Rehabilitation, Treatment outcome