Burn Orthoses

Question 1

Anterior neck burn

Answer 1

contracture tendency: neck flexion
anticontracture position: remove pillows, use half-mattress to extend neck; neck extension splint or collar

Question 2

Axilla burn

Answer 2

contracture tendency: adduction
anticontracture position: 120 degrees abduction with slight external rotation; axilla splint or positioining wedges; watch for signs of brachial plexus strain

Question 3

Anterior elbow burn

Answer 3

contracture tendency: flexion
anticontracture position: elbow extension splint in 5-10 degrees flexion

Question 4

dorsal wrist burn

Answer 4

contracture tendency: wrist extension
anticontracture position: wrist support in neutral

Question 5

volar wrist burn

Answer 5

contracture tendency: wrist flexion
anticontracture position: wrist-cockup splint in 5-10 degrees extension

Question 6

hand dorsal burn

Answer 6

contracture tendency: Claw hand deformity
anticontracture position: functional hand splint with MP joints 70-90 degrees, DIP joints fully extended, first web open, thumb in opposition (safe position)

Question 7

hand volar burn

Answer 7

contracture tendency: palmar contracture cupping of hand
anticontracture position: palm extension splint MPs in slight hyperextension

Question 8

Hip-anterior burn

Answer 8

contracture tendency: hip flexion
anticontracture position: prone positioning, weights on thigh in supine, knee immobilizers

Question 9

knee burn

Answer 9

contracture tendency: knee flexion
anticontracture position: knee extension positioning and/or splints; prevent external rotation, which may cause peroneal nerve compression

Question 10

foot burn

Answer 10

contracture tendency: foot drop
anticontracture position: ankle at 90 degrees with food board or splint; watch for sign of heel ulcer