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

Background: In a previous study, we defined the natural history of the grow th of the hand. In particular, we demonstrated that the palmar aspect of th e hand is approximately 0.78% of body surface area (BSA), We also demonstra ted a relationship between the area of the palmar surface of the hand and t he 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, Methods: 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 indiv idual were measured, and his or her BSA was calculated. The data was subjec ted to statistical and graphical analyses. Results:Hand length is an excellent predictor of BSA and body mass. Hand le ngth as a predictor of body size is independent of the gender of the subjec t and most accurate for ages 2 to 17 years, The correlation is so highly pr edictive that it is possible to derive a treatment guide based on hand leng th. 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 re d blood cells to be transfused to raise the hematocrit 3%. Conclusions: Hand length is a simple measurement that may be used as a trea tment guide. Hand length will predict body weight and body surface area ind ependently of the gender of the subject.