Ms Rhianydd Thomas^1,2, Ms Stephanie Wicks¹, Mrs Claire  Toose¹, Dr Marita  Dale³, Dr Verity  Pacey²

¹Children’s Hospital At Westmead, Sydney, Australia, ²Macquarie University, Sydney, Australia, ³The University of Sydney , Sydney, Australia

Abstract:

Background

Burns to the palmar aspect of the hand are prevalent in young children. The development of scar tissue across the flexor surface of the hand combined with the years of growth ahead can result in considerable complications.

Aim

This study was undertaken to describe outcomes of early and intensive use of a palm and digit extension splint, with the elbow immobilised at 90 degrees flexion, following a palmar burn injury.

Methods

A retrospective review of 107 children (mean age 18 months [SD 10]) treated at the Children’s Hospital at Westmead from 2012 to 2016 was performed.

Results

Three children (3%) developed contracture during the 24-month study follow-up period. The other 104 children (97%) had full ROM at 24 months or at either the point of discharge or loss to follow-up. Early signs of contracture, defined as loss of full movement or significant banding, developed in 26 children (24%) in the first 9-months following burn. With intensive physiotherapy, 23 children regained full movement by 12-months following burn. Children who did not achieve complete wound healing at 1-month following burn and children with hypertrophic scarring at 2-months following burn were significantly more represented among cases of early signs of contracture (p=.013).

Conclusion

When undertaken with regular clinical review, early and intensive use of a palm and digit extension orthosis can maintain full extension of the palm and digits in children following palmar burn injury.

Biography:

Rhianydd is a physiotherapist at the Children’s Hospital at Westmead and a PhD student at Macquarie University. Her research is focused on  splinting following palmar burn injury in young children to prevent contracture.