Clinical Specialist Hand Therapists

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Clinical Specialist Hand Therapists

• Our role in the Upper Limb Clinic

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WHO ARE WE?

• Judith Wood Clinical Specialist Occupational
  Therapist
• Nicola Hook Senior I Occupational Therapist
• Denise Lord Technical Instructor

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Who will we see?

• Our case load will be selected by consultant and
  will be identified according to specific criteria
  
• New Patient Triage
• Aims to Work up diagnosis
• Initiate surgical intervention
• Initiate conservative treatment
• Discharge

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E.g. Carpal Tunnel Assessment History Phalens
sign Sensibility gripstrengths Arrange EMG
studies in conjunction with consultant Confirm
diagnosis List for surgery Functional
assessment Splintage, ADL advice Discharge
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• Follow-up appointments
• Some patients will be discharged from the
  consultants case load following surgical
  intervention. E.g. tendon injuries, CMC jt.
  Arthritis, joint replacements and Dupuytrens
• As specialists we will continue to offer
  treatment within the upper limb setting.
• Patients will be reintroduced to the consultants
  list if complications arise. E.g.
  re-rupture

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What are the advantages to your patients?

• New patients will get an earlier appointment
  date.
• If consultant intervention is necessary, relevant
  objective assessments will already have been
  carried out. E.g non-specific wrist pain use of
  E-link, etc. TFC disruption surgery
• We will have more time to give more detailed
  information to patients.

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• Conservative management can be offered to
  alleviate functional problems whilst awaiting
  surgery. E.g. CMC jt. Arthritis splintage, ADL
  advice.
• Opportunities to address quality of life issues
  by increasing understanding, relieving symptoms
  conservatively and increasing functional
  independence. E.g CMC jt. Arthritis.

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• We will provide a holistic approach that
  recognises psychological and emotional factors.
• We have experience using validated and
  standardised assessment tools, leading to
  accurate outcome measures.

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How can we reassure patients?
By reassuring GPs
By ensuring that prospective patients have a good
understanding of the role of the Specialists
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Case Study (Dupuytrens contracture)

• Work up diagnosis e.g. contracture beyond
  critical angle 30 at PIP joint
• Patient education, options discussed
• Surgery
• Post-operative follow up, wound care, splintage
  and exercises
• Discharge

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Thank you