Rehabilitation of the burned hand.

Hands are the most frequent sites of burn injury, complications after thermal hand injury include and proper management is essential to assure that optimal functional recovery is achieved. Although each hand represents less than 3% of the total body surface area, burns to the hand are considered serious injuries and should be referred to a burn center. The thin, highly mobile dorsal skin, the sensory-enriched palmar skin, and the delicately balanced musculotendinous systems are all at risk with a hand burn. Successful management of the burned hand does not result simply from closing the wound. The hand is ranked as one of the three most frequent sites of burn scar contracture deformity. The resulting loss of function from burns that include or are specific to the hands can have a devastating effect on the numerous life roles of the patient at any age. When possible, burned hands are best treated by the entire burn center team, including physical and occupational therapists, with knowledge of burn wound healing and the potential problems that can be anticipated. This article outlines the principles of burn rehabilitation generally accepted in current burn center practice and is based more on the experience of the authors than on controlled comparative studies.