A Quick Guide to the Management of Traumatic Upper Extremity Injuries: for Entry Level Occupational Therapists

According to Kasch, Greenberg, and Muenzen (2003), occupational therapists who are initiating their entry into hand therapy or upper extremity or1hopaedic specialization do not have the knowledge and skills of an experienced therapist. This is especially true for occupational and physical therapists who enter the workforce with a general overview of many treatments but have not trained or worked in a specialized upper extremity or1hopaedic practice. Upper extremity orthopaedics is a specialty area of the occupational therapy (OT) profession which requires not only a wide range of generalized knowledge and experience, but also an extended knowledge of specific diagnostic categories and treatment. Secondary to the need to prepare students for entry-level generalized practice, many OT programs are not designed to prepare students for areas of specialized practice, including upper extremity orthopaedic therapy. Despite the absence of specialty knowledge, many students obtain employment in OT hand therapy clinics or treat patients with upper extremity dysfunction in other practice settings. While comprehensive literature exists for treating patients with upper extremity injuries, there are limited resources designed to assist entry level therapists during their transition from an OT student to a clinician in a specialty area. A literature review was conducted to obtain information on the process of specializing in OT hand therapy. Informal discussions with practicing OTs and faculty members specializing in orthopaedic upper extremity therapy were also conducted to obtain more information about hand therapy and the process of becoming a competent therapist. The product portion of this project was created after gathering information about three common traumatic upper extremity injuries, distal radius fractures, traumatic tendon injuries, and traumatic nerve injuries, and the therapeutic approaches to treat these injuries. Information was gathered from materials produced by orthopedic surgeons, general physicians, hand therapists, occupational therapists, and other medical professionals specializing in the treatment of hand injuries. The information collected culminated in the creation of a manual designed for use by entry-level occupational therapists and is presented in three sections that are congruent with the three aforementioned diagnoses. Each of the three sections of the manual provides an overview of the diagnosis being discussed as well as conm10n problems associated with each diagnosis and treatment strategies that are commonly used in the hand therapy setting. Each section also includes pictures or diagrams representing the traumatic injury, explanations of common etiology of the injury and the general symptoms that may be present. The manual also includes a a resources section which includes helpful literature, websites and associations for occupational therapists who are treating patients with upper extremity orthopaedic dysfunction I believe this product can be used by students who are interested in entering the hand therapy setting but do not feel they have the\u27 knowledge and experience to do so. Further, I believe this product will be useful for practicing therapists who work in rural settings or other settings in which patients with hand injuries are not the primary population being treated