A COTA is treating a client who sustained second- and third-degree burns on the dorsal forearm and hand. Which splint would be appropriate for this client?

• A. Resting hand splint
• B. Intrinsic plus splint
• C. Cone antispasticity splint
• D. Dorsal flexor tendon repair splint

Answer: (B)

Positioning to prevent scar contracture after burns is the key idea. For burns on the dorsal forearm and hand, the intrinsic plus splint places the hand in a posture that helps preserve web spaces and the length-tension relationships of the intrinsic muscles.

In this position, the wrist is slightly extended, the metacarpophalangeal joints are flexed, and the finger IP joints are extended. This configuration helps keep the web spaces open and avoids contractures that would limit finger motion and thumb opposition as healing progresses. It specifically counteracts shortening of structures on the dorsum of the hand and supports a functional hand posture during recovery.

Other splints don’t address this burn-specific goal. A resting hand splint is more general and doesn’t prioritize maintaining the intrinsic muscle length and web space. A cone antispasticity splint is used for tone management, not burn contracture prevention. A dorsal flexor tendon repair splint is used to protect a repaired tendon, not to guide scar prevention after burns.