During the intensive care unit phase for dorsal hand burns, which ROM technique is safest?

• A. Passively range all digits and joints at once.
• B. Passively range each digit and joint individually.
• C. Instruct the client to actively flex and extend all digits.
• D. Instruct the client to wear a resting hand splint at all times.

Answer: (B)

In the ICU after a dorsal hand burn, the priority is to protect healing tissues while preserving motion. The safest approach is to passively range each digit and its joints individually. Doing ROM this way lets the therapist control the amount of stretch and avoid excessive forces across the healing dorsal hand, tendon sheaths, and any grafts or sutures. It also minimizes shear at wound edges and allows careful monitoring of color, capillary refill, and pain for each finger.

Moving all digits at once can create larger, uncontrolled stresses across the dorsum, increasing risk to healing structures, while active movement can overload tissues that are not ready for loading. Wearing a resting hand splint all the time may immobilize the hand too much and contribute to stiffness and contractures if motion is not introduced gradually. By isolating passive ROM to each finger and joint, you promote tendon glide and joint mobility safely, setting the stage for progressive, functional recovery.