[Burn injury of the child's hand].

The treatment of the burnt hand of a child requires careful consideration of both the physical and psychological aspects involved in this programme; measures such as physical therapy, which play an important part in the treatment of adults, are of less significance. Nevertheless, due to a very low incidence of complications eg. joint stiffness, the final results are very good. Generally the recommended approach to the treatment programme is to use the closed method (i. e. dressings), whereas in such cases care on a special unit employing the open method and a topical bactericidal agent is considered advisable. When the general condition of the child permits, the surgical treatment of a third degree burn should be carried out as early as possible, rather than waiting for spontaneous escharatomy and formation of granulation tissue. Immobilisation of a wound grafted with split-thickness skin should be obtained using KIRSCHNER wires or a hay-rake splint. An early date should also be set for secondary surgical procedures involving improvement of function. Depending upon the surgical findings, flaps or free grafts may be used. It is essential that flexor contractures in the region of the PIP joints be dealt with primarily, in order to prevent the secondary formation of button-hole deformities. During follow-up examinations, growth disorders of the phalanges may be seen. These may arise as sequel to arthrodesis, or trauma to epiphyses as a result of electrical current. On the other hand, disorders of growth may also be observed in purely thermal injuries -- these are mainly confined to growth in the length. Deviation from the central axis of the finger resulting from scar tissue contracture, was not observed among our group of patients.