Keeping patients 'in good hands'

Aug 03, 2010

Hand therapy is one of the most vital treatment steps in recovery from hand injury surgery, according to a literature review published in the August 2010 issue of the Journal of the American Academy of Orthopaedic Surgeons (JAAOS). In fact, many patients spend more time with the hand therapist than the orthopaedic surgeon in the effort to ensure the best results and long-term recovery.

" therapy is the critical link between certain surgeries on the hand and a good outcome," said Erik Dorf, M.D., an orthopaedic surgeon and upper extremity specialist at Vail Summit Orthopaedics in Vail, and Frisco, Colorado, and a co-author of the review. "Collaboration and cooperation between the patient, the therapist, and the orthopaedic surgeon is critical."

Dr. Dorf added that not all hand injuries need surgery or intense therapy; but typically, injuries like tendon lacerations, or hand, wrist or finger fractures have a better long-term recovery following hand therapy.

The review found that hand therapy addresses important factors in any hand injury recovery. Some include:

  • swelling control;
  • wound management;
  • range of motion;
  • strengthening of the hand; and
  • work conditioning.
These goals are not necessarily sequential; some factors may be addressed simultaneously, depending on the injury and treatment plan. In addition, treatment may also include some combination of splinting, taping, or wrapping the hand to provide support and/or prevent swelling.

To ensure the best result after a hand injury, Dr. Dorf recommends finding a therapist who is both qualified and convenient. It is important for both the patient and treating physician to be confident in the therapist. After a qualified therapist has been agreed upon, the patient should participate in a structured therapy program and perform at-home exercises as instructed.

"If therapy is not part of the overall treatment plan, the long-term consequences can include ongoing pain, decreased range of motion, decreased strength, and difficulty with fine motor tasks," added Dr. Dorf. "The activities of daily life can become very difficult."

The article describes different modalities used by hand therapists to improve results, including:

  • Fluidotherapy (a dry heat treatment that helps range of motion)
  • Paraffin therapy (a warm paraffin wax bath that helps range of motion)
  • Cryotherapy (application of cold water to reduce swelling)
  • Various modes of electrical stimulation (to decrease fluid in the hand and accelerate wound healing)
  • Phonophoresis and iontophoresis (instillation of low dose medications into the tissues of the hand using an electrical charge or ultrasound).
Dr. Dorf also notes that persistence is important. "People want to get better quickly, but recovery from hand injuries and subsequent surgery can take a long time. Working with a hand therapist encourages patients to get involved in their own recovery by enabling them to follow the small but significant changes that occur over time."

Explore further: Allergan to cut 1,500 employees in restructuring (Update)

add to favorites email to friend print save as pdf

Related Stories

Chronic ankle pain may be more than just a sprain

May 01, 2009

Ankle sprains are a common injury after a fall, sudden twist or blow to the ankle joint. Approximately 40 percent of those who suffer an ankle sprain will experience chronic ankle pain, even after being treated ...

New surgical option for wrist arthritis

Feb 14, 2009

Breaking a fall, such as a tumble on the sidewalk, with your hands and wrists is everyone's natural reflex. But, if you fall hard enough, you'll often fracture your radius bone, or even one of the smaller wrist bones and ...

Recommended for you

Face transplants change lives, identity

8 hours ago

Patients are prepared to take significant risks in order to be considered for a face transplant, says Dr David Koppel, director of the largest craniofacial unit in the UK and Honorary Clinical Associate Professor ...

British Lords hold ten-hour debate on assisted dying

Jul 19, 2014

Members of Britain's unelected House of Lords spent almost ten hours on Friday discussing whether to legalise assisted dying, in an often emotional debate putting the question back on the agenda, if not on the statute books.

AbbVie, Shire agree on $55B combination

Jul 18, 2014

The drugmaker AbbVie has reached a deal worth roughly $55 billion to combine with British counterpart Shire and become the latest U.S. company to seek an overseas haven from tax rates back home.

User comments : 0