Outcomes after deep full-thickness hand burns

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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 degrees . 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.

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