Outcomes After Deep Full-Thickness Hand Burns

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.