The most important part of hand surgery

The most important part of hand surgery

Wrist fractures are common in the United States, and they are also one of the biggest reasons people seek the care of hand surgeons, according to Hyannis plastic and hand surgeon Peter Laub, MD. 

"One of the reasons I really love hand surgery is because I'm trying to get people back to work and back to things they like to do, whether it be crocheting or doing landscaping," he said. 

But Dr. Laub stressed that he is only one part of the recovery equation. He sees patients for a consult and then performs surgery. After about two weeks, the patient is ready for hand therapy. That's where the real work begins, he said, because no matter how successful his surgery is, if the patient doesn't do the long slow work of hand therapy, the end results are not going to be satisfactory. 

"The headline (of this story) should be: 'The real VIPs in hand surgery are not the surgeons,'" he said. "That would be the hand therapists, and the ones we have on the Cape are really great. They're like the best coach you ever had to get your hand function and wrist function back so you can get back to your life." 

What Hand Therapists Do

Hand therapy is a sub-specialty of occupational therapy that requires specific training. Hand therapists have a variety of exercises to work with using things like putty, hot sand, hot wax and scar massage. They also make custom splints when needed. 

The team effort between the surgeon and therapist is why hand therapist Jeffrey August, OTRL, loves working at Cape Cod Hospital Rehabilitation Center. The ability to communicate in a timely way with the doctors means his patients recover more quickly. 

"My goal as a therapist is to advocate for your best interest, but also I'm here to be the eyes and ears of the physician," he said. "If I see something that concerns them, I can get you back to see them quicker or know when to push forward and when to slow, because we have that direct communication that allows us to move a lot faster." 

It can also save patients a lot of visits. August said that most hand and wrist patients average about eight visits, depending on the condition. For example, a patient with arthritis might just need three or four visits, but a patient with a significant fracture or soft tissue laceration might need three to four months of therapy. 

"Most patients focus on their range of motion and their strength," he said. "I often encourage them to worry more about function. I want you to worry more about your ability to use the hand."