康复学报 (Oct 2021)
A Topic Paper on Flexor Tendon Repair: A Theoretical and Evidence — Based Approach
Abstract
For occupational therapists treating individuals with hand dysfunction, including flexor tendon repairs (FTR), it is necessary to incorporate research evidence, clinical experience, and theoretical concepts to clinically and professionally reason through evaluation and intervention. Central to guiding treatment should be occupation-based theory, as this ensures that occupation, or meaningful activities, is a core emphasis. However, providing occupation-centered therapeutic interventions is uniquely more challenging in orthopedic settings where medical and biomechanical approaches, or treatment grounded on remediation of strength and range of motion, primarily guide intervention. This topic paper uses a guided case study for a client with a zone 2 FTR, the most typical type of flexor tendon injury. Readers are guided through the clinical and professional reasoning with review of research evidence; discussion of occupation-based, tissue healing, and biomechanical theories; and application to client evaluation and intervention. Therapist intent of being client- and occupation-centered is evidenced throughout the case, with a focus on understanding the client and their perception of how the injury impacts their life. The reader is guided through identification of a specific treatment protocol for flexor tendon repair which is based on sound research evidence. This protocol is integrated with occupational, biomechanical, rehabilitative and tissue healing theories in order to provide effective intervention which meets the client's goals. Ultimately, the case study illustrates how therapy should be client-centered, evidenced-based, and grounded in theory with occupation at its foundation.
