Hand Therapist Led Follow-up for Paediatric Hand Trauma - a Retrospective Study of 139 Closed Hand Injuries

Abstract

Background: Most hand injuries in children can be managed non-operatively and are associated with excellent outcomes. Whilst the majority of our patients are discharged to the care of hand therapists, there is no literature to support this protocol. Our aim was to ensure this is safe and effective practice.

Material and methods: We conducted a retrospective analysis of all patients referred to our paediatric hand trauma clinic for closed injuries over a four month period between December 2014 and March 2015. Data related to demographics, injury pattern and clinical outcomes was recorded and analysed. A telephone interview with a patient satisfaction questionnaire was attempted with all patients discharged to the care of hand therapists.

Results: 139 patients were seen in the study period, including 90 males and 49 females. Phalangeal fractures (39%), volar plate injuries (19%) and metacarpal fractures (16%) were the commonest causes of hand trauma. The majority of patients (88%) were managed non-operatively. 97 patients were discharged to hand therapy follow-up and we managed to contact 51 patients (53%). Fifty-one patients (100%) completed a patient satisfaction questionnaire. 100% of the parents were happy with the care, 96% were not disappointed they did not see a doctor and 96% denied any complications.

Conclusion: 1. The majority of paediatric hand injuries can be managed non-operatively with excellent outcomes. 2. Hand therapy led follow-up is appropriate for a selected group of paediatric hand injuries. This study pro-ves that it is safe and effective for the majority of closed hand trauma, as illustrated by low complication rates. 3. Hand therapist led follow up for paediatric hand injuries is associated with high patient satisfaction.

Keywords: hand surgery; hand therapy; paediatric; upper limb trauma.