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JOURNAL ARTICLE
RESEARCH SUPPORT, U.S. GOV'T, NON-P.H.S.
Outcomes after deep full-thickness hand burns.
Archives of Physical Medicine and Rehabilitation 2007 December
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.
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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