Splinting, and Contracture Management

The development of burn scar contracture is a pathologic condition. Burn scar contracture is defined as a loss of motion of a joint or anatomic structure as a result of normal skin being replaced by inextensible scar tissue. The presence of a burn scar contracture has been shown to have a negative impact on a burn survivor’s quality of life, particularly in regards to physical functioning. A focus of burn rehabilitation should be to prevent or minimize contractures of the affected areas. Based on biomechanical considerations (discussed later), appropriate splinting and positioning is a critical component of any comprehensive burn rehabilitation program designed to attain optimal range-of-motion (ROM) outcomes. In 2008, a schema of burn rehabilitation phases (acute, intermediate, and long term) was developed to delineate the components of burn care treatment that are emphasized at different points in the continuum of care (Fig. 1). Table 1 describes the primary goals for positioning and splinting of burn patients during each burn rehabilitation phase.