Tanya Coats Occupational Therapy

How A Therapist Can Help With Hand Trauma

The National Electronic Injury Surveillance System (NEISS) estimates 3,468,996 upper extremity injuries are seen in the emergency room per year. According to the CDC, approximately 2.7 million annual ER visits occurred in patients 5-24 years old after sustaining a sports injury. The majority of hand traumas are work-related, but upper extremity injuries can occur anywhere: at home, during sports, at school and out in public. Injuries can result from car accidents, falls, crushing trauma, lacerations, punctures, bites, and burns which can lead to extensive damage to your hand. Fractures, dislocations or ligament injuries, lacerations causing tendon and/or nerve injury and amputations can result from these traumas, affecting daily use of our hands. The hand is one of the most complex and intricate components of our bodies. It contains multiple joints, ligaments, tendons and nerves. Our hands serve as tools to grip, lift and pinch, but also allow us to perform fine motor tasks with precision. We utilize these tools for work, play and everyday living. A hand trauma can be a devastating and traumatic experience which can limit one’s livelihood. Prompt treatment after sustaining a severe hand trauma is critical.
 
What to do after a hand trauma?
Any time the hand/finger is cut, crushed or pain persists, it is best to be evaluated by a physician. After sustaining a hand trauma, you should go to the ER or see your local hand surgeon as soon as possible to be evaluated. They may need to take X-rays or do an MRI to be able to see the extent of the injury. If you have open wounds you may need to have the wounds cleaned out to prevent infection and/or stitches placed to close the wounds. Depending on the severity of the injury, surgery may be indicated to repair the damage sustained during the accident. In some instances, you may be referred to hand therapy for custom orthotic fabrication to protect your injury and for evaluation and treatment of your hand injury.
 
What does a hand and upper extremity therapist do?
A Certified Hand Therapist and Upper Extremity Therapist (CHT) is a specially trained Occupational Therapist or Physical Therapist that specializes in the treatment of the upper extremity. They must have 4,000 hours in direct practice in hand therapy as well as a minimum of 3 years clinical experience to be eligible to sit for the national certification exam. CHTs maintain their credential by completing professional development and competency through recertification every 5 years. This specialized group of therapists has the knowledge base to deal with your hand and upper extremity injuries to ensure an optimal recovery. They work closely with hand surgeons to provide a continuum of care for the patient. CHTs work to alleviate pain and improve mobility and to maximize patients’ function after injury or surgery. Your therapist will assess swelling, wounds, scar, sensitivity, ROM, strength and coordination and the impact on your function in order to formulate a comprehensive therapy plan that is just right for you while taking into consideration your lifestyle and goals. This collaborative approach ensures that your specific needs are addressed.
How can a hand and upper extremity therapist help me after a hand trauma?
Hand and upper extremity therapists can fabricate custom orthoses or splints to protect fractures, nerve and/or tendon repairs. They can perform wound care to maximize healing of wounds and to manage scars to prevent interference with regaining your motion. Hand and upper extremity therapists can educate you in desensitization to decrease sensitivity in your upper extremity during the healing process. Your therapist will work with you to help to get your range of motion (ROM) back, as well as your coordination and strength. Patients will be educated in functional activities to prepare for return to work or other valued daily tasks. With improved movement in your upper extremity, hand and upper extremity therapists will work with you to get back to what is important and meaningful to you.

Article Reference: ASSH Handblog

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