Current rehabilitation recommendations following primary triangular fibrocartilage complex foveal repair surgery: A survey of Australian hand therapists

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McCarron, Luke
Coombes, Brooke K
Bindra, Randy
Bisset, Leanne
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2023
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Abstract

Background: Following injury to the Triangular Fibrocartilage Complex (TFCC), foveal repair surgery may be indicated to restore joint stability and function. Protection of the repaired ligament is a clinical consideration during post-surgical rehabilitation, although no “gold standard” rehabilitation protocol currently exists. Purpose: To describe the professional opinions of Accredited Hand Therapists (AHT) regarding post-operative rehabilitation recommendations following TFCC foveal repair surgery. Study Design: Cross-sectional descriptive study. Methods: All Australian AHTs were invited to complete a quantitative, online, 10-item survey between December 2019 and March 2020. The survey included questions regarding clinical recommendations for wrist and forearm immobilization, range of motion and exercise methods, and timeframes. AHT characteristics and experience of patients sustaining a TFCC re-rupture were also collected. Categorical and nominal survey responses were reported descriptively and effects of AHT characteristics on survey responses were assessed using Pearson Chi2, with significance set to <0.05. Results: Survey responses were received from 135 AHTs or approximately 37% of the available population at the time of completion (March 2020). Recommendations for post-surgery immobilization ranged from “not required” to 8 weeks, 6 weeks representing the most common answer. Wrist and forearm range of motion commencement time ranged from “immediately” to “later than 8 weeks,” with 6 weeks also the most common answer. When asked whether post-surgery rupture had been experienced in their respective patient groups, 15 therapists (11%) indicated “Yes.” The most recommended thermoplastic orthosis was a Sugartong orthosis (41%) followed by a Muenster orthosis (30%), both of which immobilizes the wrist and forearm. Conclusions: Rehabilitation varied widely between AHTs. Further prospective research is recommended to explore whether patient-related or rehabilitation factors influence outcomes following TFCC repair.

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Journal of Hand Therapy

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© 2023 The Author(s). Published by Elsevier Inc. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

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Subject

Rehabilitation

Surgery

Allied health and rehabilitation science

Hand therapy

Ligament repair

Rehabilitation

Triangular fibrocartilage

Wrist

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McCarron, L; Coombes, BK; Bindra, R; Bisset, L, Current rehabilitation recommendations following primary triangular fibrocartilage complex foveal repair surgery: A survey of Australian hand therapists, Journal of Hand Therapy, 2023

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