Don’t let hand injuries get out of hand

by Dr Cameron Mackay – Hand and plastic surgeon

Best practice

It’s important to ensure hand injuries are promptly diagnosed and treated. Rehabilitation and return to work coordinators should ensure a clear and consistent diagnosis is available early in the injury management pathway.

Why this is important

The hand is an important and complex structure. An injured hand is likely to have a major impact on personal and occupational functional capacity. An early, specific and accurate diagnosis is essential to achieving a positive and timely recovery. Misdiagnosis or delayed treatment can lead to prolonged recovery and poor outcomes.

Your toolkit

Here are some key points and a checklist for maintaining a positive trajectory with hand injuries.

• Evaluate information available and ensure there is a medical diagnosis and clear management plan. Is the injury and the plan specific and well documented?
• Remember that repetitive strain injury (RSI) is not a diagnosis but rather an umbrella term for a multitude of possible activity related pathology and disorders. To reduce the risk of further sprain or strain injuries review the task using this worksheet.
• Ask the injured worker if they feel they have been listened to and examined. Do they feel they have an answer and a pathway to recovery and safe return to work? Do they feel the workplace need to review the task to make sure the risk of re-injury has been addressed appropriately?
• Consider re-evaluation in four weekly blocks. If no progress is achieved over four weeks, seek more information from the insurer and ask them to consider seeking a second opinion or independent medical examination (IME).
• Usually, safe duties can be found for a worker who has injured one hand, although these duties may not be available at the primary place of work. The insurer can work with you to help find suitable duties for the worker.

Hand injury checklist:

• undertake an anatomical diagnosis
• document clear treatment pathway in a rehabilitation and return to work plan by the insurer
• provide early intervention, active treatment
• positive trajectory at four week review
• offer early return to suitable duties where possible
• provide a positive, supportive work environment
• what to do after a sprain or strain injury
• provide information on managing the risks of using knives at work.

Most of all, remember that our hands do not like to be neglected. Even when injured, hands need to be cared for, stimulated and moved as much as possible.

Many hand injuries are simple. Treat them early, treat them well.