The Natural History of the Growth of the Hand: I. Hand Area as a Percentage of Body Surface Area

Abstract

The use of a patient's own hand as a tool to estimate the area of burn injury is well documented. The area of the palmar surface of one hand has been estimated to be 1 percent of the body surface area. The area of the palmar surface of the hand was measured to test the accuracy of this estimate and then compared with the body surface area as calculated by formulas in common use. This study also sought to determine the natural history of the growth of the hand to permit development of a readily available, bedside means of estimating hand area and body surface area. Bilateral hand tracings were obtained from 800 volunteers ranging in age from 2 to 89 years. The area of each tracing was determined using an integrating planimeter. The height and weight of each individual were measured, and his/her body surface area was calculated. The palmar hand's percentage of body surface area was determined by calculating the quotient for hand area divided by body surface area. Additionally, the width of the hand was measured from the ulnar aspect at the palmar digital crease of the small finger to the point where the thumb rested against the base of the index finger. The length of the hand was measured from the middle of the interstylon to the tip of the middle finger. These two figures were multiplied together to obtain a product which approximated the area of the hand. Based on the most commonly used DuBois formula for calculating body surface area, the area of palmar surface of the hand corresponds to 0.78 +/- 0.08 percent of the body surface area in adults. The percentage varies somewhat with age and reaches a maximum of 0.87 +/- 0.06 percent in young children. Multiplying the length of the hand by its width overestimates the area of the hand as determined by planimetry by only 2 percent. A patient's own hand may be used as a complementary, readily available template for estimation of burn area or other areas of disease or injury. In adults, the area of tracing of the outline of the hand is 0.78 percent of the body surface area, whereas in children, this number tends to be slightly higher. In the emergency room or on the wards, a simple product of length multiplied by width of the hand will closely approximate the area as determined by planimetry. This method allows a more accurate determination of the area of the palmar surface of the hand than the 1 percent estimate, which may lead to an overestimation of the size of a burn wound in adults.

Revisions to the staging and classification of mycosis fungoides and Sézary syndrome: a proposal of the International Society for Cutaneous Lymphomas (ISCL) and the cutaneous lymphoma task force of the European Organization of Research and Treatment of Cancer (EORTC)

“…In the classification published by the MFCG in 1979, 1% BSA was defined as equal to the "palmar surface of the hand." 5 However, the area of the palm and digits together is actually slightly less than 1% BSA (ϳ 0.8%), [31][32][33][34] and mathematically and reliably, the palm at 0.5% BSA 31,34 may be the easiest and most reliable measure to use in assigning BSA of lesions of MF or SS. Another method of determining BSA is to estimate the percentage of skin involvement in each of 12 regions of the body (each with a relative assigned percent BSA 35 [ Figure 1]), multiplying this number by the percentage of the BSA for that particular region and adding up the regional percentages to obtain the total BSA involved with MF/SS.…”

Optimal Handle Grip Span for Maximum Hand Grip Strength and Accurate Grip Control Strength Exertion According to Individual Hand Size

“…Assessment of hand size: Hand size was measured in both hands at maximal length and by measuring the length of hands simply stretch out the palm up and use a measuring tape from the base of hand to the tip of middle finger [29][30][31]. The results of hand size were therefore rounded to the nearest whole centimetre.…”

Correlation of Human Height With Hand Length in Indian Individuals

“…In such situations it can be done from hand length and prints or from foot length and prints [5]. Hand length has been documented as significant predictor of body surface area and body mass [6].…”