Affiliation:
1. Department of Physiotherapy, School of Health and Rehabilitation Sciences, Faculty of Health Sciences, University of Free State, Bloemfontein, South Africa
2. Department of Physiotherapy, School of Therapeutic Sciences, Faculty of Health Sciences, University of Witwatersrand, Gauteng, South Africa
Abstract
Introduction: Metacarpal fractures are viewed as minor injuries, potentially leading to reduced hand function and productivity, especially in working-age people. The study aimed to develop and finalise a second to fifth metacarpal fractures clinical hand rehabilitation guideline. Methods: A three-round eDelphi method, employing REDCap questionnaires and informed by a previous clinical hand rehabilitation guideline, facilitated expert consensus. Experience and qualifications guided expert selection. Consensus was defined as 75% or more experts selecting four or five on a Likert scale or ‘yes’ in ‘yes/no’ questions. Open-ended responses were incorporated, following Conducting and Reporting of Delphi Studies recommendations. Results: Fifteen experts specialising in hand injury management, including orthopaedic surgeons, occupational therapists and physiotherapists, were invited to participate, with attrition of one expert in three rounds. In Round 1, 10 (28.5%), Round 2, 6 (18%) and Round 3, 16 (36%) guideline statements were accepted. Consensus was reached for including grasp types in rehabilitation; activities of daily living (ADLs) types under light, medium and heavy categories; time when early active mobilisation should commence and splint types after conservative management, K-wires and surgical fixation. Conclusion: The finalised clinical hand rehabilitation guideline based on the Occupational Therapy Intervention Process Model (OTIPM) framework may benefit occupation return.
Reference32 articles.
1. Outcome of Conservative Management of Spiral/Long Oblique Fractures of the Metacarpal Shaft of the Fingers Using a Palmar Wrist Splint and Immediate Mobilisation of the Fingers
2. AGREE II: advancing guideline development, reporting and evaluation in health care
3. Fisher AG (2009) Occupational therapy intervention process model: A model for planning and implementing top-down, client-centered, and occupation-based interventions. Available at: https://www.semanticscholar.org/paper/Occupational-therapy-intervention-process-model-%3A-a-Fisher/3554d287f953132e494c0b5f48cacdaf663be45d (accessed 30 January 2024).
4. Fisher AG, Jones KB (2017) Occupational therapy intervention process model. In: Perspectives on Human Occupation-Theories Underlying Practice, 2nd edn. Philadelphia, PA: Three Star Press Inc, pp.237–86. Available at: https://books.google.co.za/books?hl=en&lr=&id=Sfm_DgAAQBAJ&oi=fnd&pg=PA237&dq=occupational+therapy+intervention+process+model&ots=SkRiOP-6nM&sig=cABQOa-yi4cQGqmKYHCT6VGK1KU#v=onepage&q=occupational%20therapy%20intervention%20process%20model&f=false (accessed 30 January 2024).