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Splinting the pediatric Palmar burn
C Schwanholt1, M B Daugherty, T Gaboury
1Shriners Hospitals for Crippled Children Burns Institute, Cincinnati, OH 45229-3095.
Insights
Deep palmar burns in young children are challenging. A new splinting technique effectively prevents contractures by positioning the hand in an antideformity position, aiding recovery in acute and reconstructive burn cases.
Area of Science:
- Pediatric burn care
- Orthopedic surgery
- Rehabilitation medicine
Background:
- Deep palmar burns in children under 4 present significant challenges.
- Hand flexion at rest and during activity commonly leads to flexion contractures.
- Maintaining an antideformity position is crucial for preventing long-term functional impairment.
Purpose of the Study:
- To evaluate a novel splinting technique for managing deep palmar burns in pediatric patients.
- To assess the efficacy of the splint in maintaining an antideformity position.
- To determine the utility of the splint in both acute burn management and post-reconstructive care.
Main Methods:
- A splint was designed to position the wrist in extension and the metacarpophalangeal joints (digits 2-5) in hyperextension.
- The technique was applied to 15 hands across 11 patients (9 acute burns, 2 reconstructions).
- Clinical evaluation focused on the ability to maintain the antideformity position.
Main Results:
- The splinting technique successfully maintained the antideformity position in all evaluated patients.
- This method proved effective for both acute burn injuries and hands undergoing reconstructive procedures.
- No complications related to the splinting technique were reported.
Conclusions:
- The evaluated splinting technique is a successful method for preventing contractures in pediatric palmar burn injuries.
- This approach is valuable for both initial burn management and after surgical reconstruction.
- Effective splinting is key to preserving hand function in young burn survivors.
Abstract:
Children younger than 4 years of age who have sustained deep palmar burns pose a significant challenge to the burn care team. Flexion contractures of the palm and digits are all too common because the hand is maintained in flexion when at rest and while engaged in functional activities. A splint that positions the wrist in extension and the metacarpophalangeal joints of digits 2 to 5 in some hyperextension was evaluated. Nine patients with acute burns and two patients who required palmar reconstruction were studied. (The total number of hands was 15.) With this splinting technique, we have successfully maintained the antideformity position in patients with acute injuries and in those who have undergone reconstructive procedures.