Natural history of the growth of the hand: part II--hand length as a treatment guide in the pediatric trauma patient.

Abstract

In a previous study, we defined the natural history of the growth of the hand. In particular, we demonstrated that the palmar aspect of the hand is approximately 0.78% of body surface area (BSA). We also demonstrated a relationship between the area of the palmar surface of the hand and the total BSA as growth proceeds. Seeking to improve the usefulness of hand size as a guide to predicting body size, we examined the length of the hand as a predictor of body mass and BSA. Bilateral hand tracings were obtained from 800 volunteers ranging in age from 2 to 89 years. The hand tracings were measured, and the length and width of the hands were determined. The height and weight of each individual were measured, and his or her BSA was calculated. The data was subjected to statistical and graphical analyses. Hand length is an excellent predictor of BSA and body mass. Hand length as a predictor of body size is independent of the gender of the subject and most accurate for ages 2 to 17 years. The correlation is so highly predictive that it is possible to derive a treatment guide based on hand length. The length of the hand predicts body weight and BSA and can be used to predict baseline intravenous fluid requirements and the volume of packed red blood cells to be transfused to raise the hematocrit 3%. Hand length is a simple measurement that may be used as a treatment guide. Hand length will predict body weight and body surface area independently of the gender of the subject.