Experience with skeletal immobilization after excision and grafting of severely burned hands

The use of skeletal immobilization with 'hayrakes' and 'banjos' after excision and grafting of 68 severely burned hands was reviewed. It is ideally used in the patient with wounds that are circumferential or extend onto the forearm or when the patient will likely need continuous passive range of motion postoperatively. Serious infectious complications which could be directly attributed to the skeletal traction itself were rare. Peripheral nerve and arterial injuries were not encountered. The use of this technique when joints or tendons are involved or when the hands are easily splintable is not recommended. It appears to be a safe technique and results in excellent sheet graft take and hand function.