1

ORTHOSIS FOR
BURN AND SOFT
TISSUE
DISORDERS

Presented To: Dr. Rida

 IMPORTANCE OF
ORTHOSIS FOR
BURN AND SOFT
TISSUE DISORDER
Presented By:
Azbah Haider
Laiba hashmi
CONTENT
Definition
Degree of burn
Type of soft tissue disorders
Importance of orthosis
Benefit of orthosis
​
​
DEFINITION
BURN
IMPORTANCE OF ORTHOSIS FOR BURN
6
AND SOFT TISSUE DISORDER

BURN
• can be defined as any injury
that result from the direct
contact or exposure to any
thermal, chemical, electrical
or radiation source
 7

FIRST DEGREE
BURN

• It involves only epidermis.

• It produces pink to reddish
color on burned skin.
• In involve minimal tissue
damage.
SIGN AND SYMPTOM:
• Redness
• Pain
• Swelling
 8

SECOND DEGREE
BURN
• It involves epidermis and
portion of dermis.
• Often involve other structure
such as sweat gland, hair
follicles.
SIGN AND SYMPTOM:
• Severe pain
• Swelling
• blisters
 9

THIRD DEGREE
BURN
• It involves epidermis, dermis
and hypo-dermis.
• Both epidermis or dermis are
destroyed
• They produce deep scars
Sign and Symptoms:
• Dry and leathery skin
• Black, white , brown or yellow skin
• Swelling
• Lack of pain because nerve ending
have been destroyed
 10

IMPORTANCE OF
ORTHOSIS FOR BURN
POSITIONING AND
SPLINTING:

It is imperative that a burn

patient be positioned and splinted
as soon as the injury occurs for
the best functional outcomes of
his rehabilitation. Therefore,
positioning and splinting should:

• Minimize edema formation.

• Prevent tissue destruction.
• Prevent contracture.
• Maintain soft tissue in an
elongated state to facilitate
recovery.
 11

IMPORTANCE
OF ORTHOSIS
USE
For patients with burns injury, splints are
used to hold parts of the body so that:

• The skin graft can be immobilized and

protected while healing.
• The skin can be prevented from
shrinkage and contractures while
healing.
• The new grafts and flaps are
protected.
• The deformity is prevented and/or
corrected.
• The ROM is maintained and/or
increased.
 12

DEFINITION
WHAT IS SOFT TISSUE?

• Soft tissues are the layers that

protect underlying body
structure.
• Soft tissue refers to all
tissues in the body that are
not bone.
• It include muscle, fat , fibrous
tissue , blood vessel or any other
supporting tissue of the body
 13

SOFT TISSUE
DISORDER
• rotator cuff tendinopathy
• bicipital tendinopathy
• subacromial bursitis
• olecranon bursitis
• epicondylitis
• De Quervain disease
• trigger finger
• knee bursitis
• Baker cyst
• plantar fasciitis
• Achilles tendinopathy.
IMPORTANCE OF 14

ORTHOSIS FOR
SOFT TISSUE
DISORDERS
The aim of orthotics is to increase the
efficiency of function during acute or
long term injury, this includes soft tissue
and bony injury as well as changes as a
result of neurological changes. They can
be an effective adjunct alongside
physiotherapy techniques such as muscle
strengthening and stretches, gait and
balance retraining and reach and grasp
strategies
 15

BENEFITS OF
ORTHOSIS FOR
UPPER LIMB
• prevent or correct deformity reducing
pain and maximizing function in
reach and grasp tasks.
• Improve the efficiency of reach and
grasp tasks
• Offload an injured limb to allow
healing
• Reduce need for compensation of
ipsilateral and contralateral limbs and
secondary pain
• Improve role of the upper limb in
maintaining balance
 16

BENEFITS OF
ORTHOSIS FOR
LOWER LIMB
• prevent or correct deformity and
reduce pain during weight-
bearing
• Improve the efficiency of gait
and maintain balance
• Improve base of support / lateral
support
• Reduce need for compensation of
ipsilateral and contralateral limbs
and secondary pain
• To facilitate training in skills
ORTHOSES FOR BURN
MANAGMENT

PRESENTED BY :
Aleena Noor
Zerfishan Iftikhar
Adeeba Tabbasum
 TABLE OF CONTENT
• Introduction to burn
• Burn Care 6 C s
• Splint Design
• Indications
• Positioning and Splinting
• Deformities
• Classification
• Types
 Introduction

• A burn is an injury to the skin or other organic tissue primarily

caused by heat or due to radiation, radioactivity, electricity,
friction, or contact with chemicals
• Most burns are due to heat from hot liquids (called scalding),
solids, or fire.
• A splint is a rigid support made from metal,
plaster, or plastic. It's used to protect, support,
or immobilize an injured or inflamed part of
the body.
• The specific use of orthoses in burn
management can vary depending on the
severity and location of the burn, as well as
the individual's needs.
 6 Cs

• A systematic approach to burn care

focuses on the six “Cs”: clothing, cooling,
cleaning, chemoprophylaxis, covering and
comforting (i.e., pain relief).
 Splint design
• Should be kept simple so that a splint is easy to apply, remove,
and clean.
• Usually worn at night, when pt is resting, or continuously for
several days following skin grafting.
• Splints should conform to the body parts, and care must be
taken to ensure that there are no pressure points that may
cause a breakdown in healing or normal skin.
 Indication for Splint Use
Splints are generally used for:
• Prevention of contractures
• Protection of a joint or tendon
• Immobilization following a skin graft
• Decreased Range of Motion (ROM)
• Maintenance of ROM obtained while exercising or during a
surgical release
• Poor patient compliance
 For patients with burns injury, splints are used to hold parts of the body so that:

• The skin graft can be immobilized and protected while healing

• The skin can be prevented from shrinkage and contractures
while healing
• The new grafts and flaps are protected
• The deformity is prevented and/or corrected
• The ROM is maintained and/or increased
• The weak muscles can counteract the effect of gravity
 Deformities
Pathophysiology
The typical deformities seen in the burned hand are
• Hyperextension deformity of the
metacarpophalangeal joints,
• Flexion deformity of the interphalangeal (IP) joints,
• Adduction contracture of the thumb,
• Volar flexion contracture of the wrist, and shrinkage of
the dorsal skin.
• The metacarpophalangeal joint assumes the
hyperextended position because of with joint edema.
 Dorsal Burn
• The most common deformity after a dorsal
burn injury of the hand is the ‘‘clawhand’’
deformity, which positions the hand with the
• wrist in 15 to 30 degrees of extension,
• the MP joints in 70 to 80 degrees of flexion,
• IP joints straight, and the thumb abducted.
 Palmar Burn
• Palmer hand burns require thorough evaluation to determine
the type of splinting required.
• In general, the palmar skin will require maximum stretching to
prevent the contracting forces of the healing burn.
Positioning
The antideformity position of
the palmar burn consists of
• wrist extension
• MP joint extension
• IP joint extension
• digital abduction
• thumb abduction and
extension: the ‘‘open
palm’’ or ‘‘pancake’’
position.
 Dynamic Splint

When a patient is unable to

actively close the fingers into
the palm, a dynamic splint can
be fashioned that utilizes
rubber bands to passively
encourage the digits to flex
into the palm.
Dynamic splint

• To correct adduction
contracture that occur
in patient with web
space burn
 Classification
There are 3 main types of splints usually used with burn patients
namely
• Static
• Static progressive
• Dynamic splints
• Static or Primary splints are used in the acute
phase for skin graft protection after surgery or anti
contracture positioning. These splints are applied to
adjacent intact skin.
• Static progressive or postural splints are used after
the graft phase when there is no sufficient ROM
obtained with static positioning and exercise. These
splints may be implemented for correction and
contractures.
• Dynamic or follow-up splints are used to increase
function by providing a slow force to stretch a
contracture or provide resistive force for exercise
 Types of splints & Orthoses for burns

There are several types of splints and orthoses we may

use to treat our burns.
• Resting Hand splints
• Finger extension splint
• Interdigital inserts
• Clavicle strap
• Axillary Splint
• Mouth Splint
• Spinal orthoses
• Foot orthoses
 Resting hand splint for burns

• Resting hand splints are used to support the hand and wrist
joints so that they heal without losing range of motion. While
burns heal, the skin can shrink which may cause contractures
and deformities.
• These splints are worn while you’re resting and hold your hand
in a comfortable position to reduce swelling and pain.
• A common schedule would be to wear it at night while sleeping
and take it off during the day for exercise and activity.
 Finger extension splints for burns

• The purpose of finger extension splints is to support a finger

joint so that it heals without contracting. This helps prevent
deformities.
• It’s common to wear finger extension splints at night while
resting and take them off during the day while exercising or
doing other activities.
 Interdigital inserts for burns

• Interdigital splints are inserts that you wear in the web spaces
between your fingers and thumb.
• They’re used to prevent the skin from shrinking as it heals and
to restore range of motion by stretching the skin.
• How long and when you wear them varies, but patients usually
wear them full-time under compression glove
 Clavicle strap for burns
• A clavicle strap can prevent the skin around your arm and
clavicle from shrinking while you recover. It also helps maintain
your range of motion by keeping your skin loose and healthy.
The length of time you’ll wear the clavicle strap varies
depending on your specific burn injuries. You might wear it full-
time or part-time
 Axillary or airplane splint for burns

• An airplane splint, sometimes called an

axillary splint, is used for burns on the
shoulders or underarms (axilla). It’s called an
airplane splint because it holds your arm out
to the side, like an airplane wing.
 Mouth splints for burns

• If the skin around your mouth shrinks, you can develop a

condition called microstomia.
• Microstomia makes it difficult to open your mouth, eat, speak
clearly, brush your teeth and complete dental work.
• There are a variety of mouth splints available, some of them are
prefabricated and some are custom made to each patient.
• Most people wear mouth splints on a part-time schedule 2-4
times a day.
 Spinal Orthoses
• Burns on the back or torso may require the use of spinal
orthoses
• such as back braces or support garments, to protect and
stabilize the injured area during the healing process
 Foot Orthoses
• Burn injuries on the feet can cause deformities and difficulties
with walking.
• Custom-made foot orthoses, such as insoles or shoe
modifications, can help distribute pressure, support the arches,
and improve gait
 Points To Remember
• It's important to note that the use of orthotic devices in burn
management should be guided by a healthcare professional,
such as a physical therapist, occupational therapist, or a burn
specialist.
• Customization is often necessary to address the unique needs
of each patient and their specific burn injuries.
• Additionally, proper patient education and follow-up care are
essential for achieving the best outcomes in burn management
with the use of orthoses
Orthoses for patients
with soft tissue
problems associated
with neuromascular
disorder
Shama khan
Areej Nazir
Hina yakoob
 What are neuromascular conditions?
• The term ‘neuromuscular
conditions’ broadly means any
illness or
• disease affecting the nervous system
and muscles of the body.
• Common examples include:
• • Cerebral palsy
• • Stroke
• • Spinal cord injury
• • Post-polio syndrome
• • Muscular dystrophies
• • Spinal muscular atrophy
• • Charcot Marie Tooth disease
• • Multiple sclerosi
 How do orthoses help people with
neuromascular conditions?

• Compensating for muscle weakness

• Accomodating,protecting and
preventing deformity
• Perform a clinical assessment
• Support you to determine the most suitable orthosis to
• meet your goals and requirements,
• Complete the measurement/casting, manufacture and
fitting
• Provide ongoing clinical support and education including
• regular reviews
• Adjust and/or replace the orthosis to maintain an optimal
fit
• Liaise with relevant members of the healthcare team
Orthoses used