• Rhianydd Thomas, Stephanie Wicks, Marita Dale, Claire Toose, and Verity Pacey.
• Department of Health Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, New South Wales, Australia; Burns Unit, The Children's Hospital at Westmead, New South Wales, Australia. Electronic address: rhianydd.thomas@hdr.mq.edu.au.
• Burns. 2024 Apr 1; 50 (3): 717729717-729.

BackgroundPalmar burn injuries are common in young children and can result in contracture.MethodsA prospective longitudinal study describes outcomes of palm and digit extension splint use following burn in 75 children (83 hands) aged < 5 years and determines whether specific cutaneous functional units (CFUs) are associated with early signs of contracture (ESC). Outcomes were assessed up to 9-18 months following burn. Routine clinical data was collected at therapy reviews.ResultsChildren were splinted > 12 h/day for a mean of 158 days following burn. The mean time to splint cessation was 264 days following burn. Fourteen hands developed ESC (17%): 12 hands had full ROM restored following conservative management, 2 hands (3%) progressed to contracture. Hands that developed ESC had greater healing time (p = 0.002), greater number of CFUs affected (p < 0.001), and greater number of immediate first webspace and extended first webspace CFUs affected (p = 0.002, p < 0.001 respectively). ESC risk increases for each day to heal (odds ratio [OR] 1.1, 95% CI 1.0-1.2) and each CFU in extended first webspace (OR 2.8, 95% CI 1.5-5.0).ConclusionEarly and intensive splinting following palmar burn results in excellent ROM. Burns involving more CFUs or the first webspace are associated with ESC.Copyright © 2024 Elsevier Ltd and International Society of Burns Injuries. All rights reserved.

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