What are the rehabilitation treatments for clawed hands after burns?
01
Pressure therapy: This is currently the most effective and safe anti-scar treatment measure. It can prevent and treat scar hyperplasia by affecting the microcirculation in the scar, reducing collagen synthesis, and remodeling the scar. The key to treatment is appropriate pressure and wearing time not less than 23 hours.
02
Good limb placement: keep the functional or anti-contracture position of the hand: abduct the thumb to the palm, slightly extend the wrist, naturally flex the metacarpophalangeal joints by 50-70°, straighten the interphalangeal joints, and place gauze between each finger The roll prevents the webs from sticking, and orthotics can be used to fix them if necessary.
03
Scar massage: Burn scar massage needs to be performed after the wound is completely healed. It can accelerate blood circulation, enhance the skin's repair ability, and make the scar tend to soften and smooth. In the early stage, gentle massage, rubbing, and kneading methods were adopted, and the techniques and parts were changed frequently, 1-2 times a day, 30 minutes each time.
04
Active and passive mobilization: For patients with joint involvement after burns, active mobilization should start after the injury until hand function improves, while for patients who have undergone surgical treatment, it should start after the skin graft survives. Active muscle contraction facilitates lymphatic drainage in the hands and upper extremities. ① Functional activities of flexion and extension of each joint of the hand: perform finger flexion, finger pointing, and fist movement. Hand flexion and extension should be carried out in the order of metacarpophalangeal joints, proximal interphalangeal joints and distal interphalangeal joints, and at the same time thumb abduction and palm-opposite functional activities. ② Fully unfold the tiger's mouth and each finger web. ③ Functional activities of wrist flexion and extension.
05
Orthotics: In the early stage, they are mainly used to protect or assist limb placement, promote tissue healing, and prevent contractures and deformities; in the middle stage, they are mainly used to resist contractures, improve joint mobility, and restore limb functions to the maximum extent; in the later stages, they are mostly used to correct deformities.
06
Sensory training: Promote the brain to re-understand this part of the changed signal, and promote the normalization of sensation, including sensory re-education and desensitization therapy, which can improve proprioception by grasping objects of different shapes and textures with the affected hand.
07
Fine function training: Repeated and accurate practice is the key to fine function training. Generally, you can choose to screw, pick up beans, pick up coins, count money, etc., to train the flexibility and coordination of hands.
08
ADL training: When formulating training plans, the hand function of patients in different periods should be considered. Individualized training programs can not only help patients complete basic ADL activities independently, but also maintain and improve limb functions. and social participation ability have been improved, which can help them rebuild their confidence in life.
