Positioning and Splinting of Joints

Although hands represent a relatively small wound area in a burn, they can cause significant disability if healing is not carefully managed. The care required to manage a hand burn does not always mean that a child has to be admitted to the hospital. Many hand burns can be treated on an outpatient basis, with only occasional admissions for surgery or other procedures.

Positioning

Positioning hands can prevent the hands from contracting, or pulling into a claw-like position as the skin heals and scars form. Because this kind of contracting can’t be repaired by later reconstructive surgery, it’s important to begin treatment as soon as possible after injury. Several factors are taken into consideration when positioning the hands, including the age of the patient and his or her ability to participate in therapy or other treatment. But in general the hands will be positioned to allow maximum stretching of the collateral ligaments.

Splinting

There are two types of splints used in hand therapy, static and active. Static splints are most often used when the patient is unable to cooperate or participate in hand care, or while the patient is sleeping. Active splints allow the patient to use his or her hands for self-care, occupational therapy and other activities as the wounds heal. Splints are continuously adjusted to allow the ligaments to stretch, facilitate hand mobility, and allow normal thumb-finger interaction.

Occupational Therapy

Occupational therapy can make a significant difference in hand function following a burn injury. At Shriners Hospitals for Children^® an occupational therapist will often assess the patient within 24 hours of the injury to determine mobility and function. Occupational therapy treatment sessions are designed to return the hand to maximum functional ability.