A protocol advocating delayed surgical management of pediatric treadmill friction burn of the hand

• Main Author: Adnan Ghazi Gelidan
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2020-01-01
• Series: Journal of Nature and Science of Medicine
• Subjects: friction burn; hand; surgical management; treadmill
• Online Access: http://www.jnsmonline.org/article.asp?issn=2589-627X;year=2020;volume=3;issue=3;spage=204;epage=209;aulast=Gelidan

Introduction: Treadmills are common exercise machine used in households. The high-speed running pad can result in serious injuries to children's hands in the form of friction burns. These friction burns can be severe enough to require surgical intervention and prolonged wound care, frequently resulting in hypertrophic scarring and functional contracture. Materials and Methods: Retrospective data were collected for all pediatric patients who underwent surgical procedure for digit contracture secondary to treadmill friction burn between January 2017 and October 2019. Collected data included age, sex, percentage of burn, number of digits involved, duration of nonsurgical conservative treatment, course of surgical treatment, joints involved, degrees of joint flexion, and skin graft donor sites. Results: A total of 13 patients with a mean age of 4.77 years underwent delayed surgical correction of digit flexion contracture secondary to hypertrophic scar that involved the metacarpophalangeal joint, proximal interphalangeal joint, or distal interphalangeal joints that involved release of contracture full thickness skin graft (FTSG), and Kirschner (K-wire) fixation. Middle and ring fingers were the most commonly affected, with the left hand more involved than the right (9:4). Conclusion: Pediatric friction treadmill burn injury is a rising public health issue. The victims are mainly children younger than 10 years of age. The volar hands and digits are most frequently affected. Resulting flexion contracture will significantly affect hand function. In our series, delayed release of contracture, FTSG, and K-wire fixation was a treatment protocol which resulted in excellent preservation of hand function and minimal complication.