In 2020, WorkSafeBC’s Hand Therapy Program treated 4630 injured workers, slightly fewer than the 4841 treated in 2019. The goal: to provide timely, specialized treatment to help injured workers get back on the job as soon as it is safe to do so. The program is delivered through our contracted network of 46 hand therapy clinics around the province. These clinics, staffed by certified hand therapists, provide services to workers who have sustained injuries to the upper extremity, below shoulder level.

Referrals

Workers either self-refer to one of the clinics or are referred by a family physician, a hand surgeon, or WorkSafeBC. Physicians may refer an injured worker patient directly to one of the contracted hand therapy providers or recommend to the case manager that the injured worker be referred to the program.

Hand injury treatment: An example

The following example illustrates how a typical hand injury might be treated within our hand therapy framework.

A 23-year-old carpenter—we’ll call him Rick—suffered a laceration to the right index finger extensor tendon, with a mallet deformity, when he hit his hand against a sharp piece of rebar. Rick saw his family physician the day of his injury and attended an orthopaedic consultation 10 days later. At the consultation, the orthopaedic physician recommended splinting to address the 15 degree lag at the DIP joint. The worker returned for suture removal 1 week later. With the wound healing, the physician recommended referral to a certified hand therapist, and the WorkSafeBC claim owner initiated the referral process to WorkSafeBC’s Hand Therapy Program.

One week later, Rick had an assessment at one of WorkSafeBC’s certified hand therapy clinics, 1 month after his injury. On assessment, the hand therapist noted that the injury was healing, but there was some skin breakdown from the bandages. The certified hand therapist fabricated a new splint to hold the DIP joint in slight hyperextension and the PIP joint in flexion. Rick attended the Hand Therapy Program for splinting, progressive range of motion, strengthening, and return-to-work planning. The Hand Therapy Program coordinated and initiated a graduated return-to-work plan, which the worker initiated after 2 months of treatment.

Rick participated in a 3-week graduated return-to-work plan monitored by the certified hand therapist. After completing the graduated return-to-work plan, the worker was discharged from the Hand Therapy Program fit to return to work with no limitations and no permanent functional impairment.

Further information

For more information on WorkSafeBC’s Hand Therapy Program, please contact the Health Care Programs team at 604 232-7787 or toll-free 1 866 244-6404, or visit the hand therapy page at www.worksafebc.com/en/health-care-providers/rehabilitation/hand therapy.

If you have questions regarding a specific worker patient’s hand injury, please call a medical advisor in your nearest WorkSafeBC office.
—Linda Calvert, BScPT
WorkSafeBC Program Manager, Health Care Programs

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This article is the opinion of WorkSafeBC and has not been peer reviewed by the BCMJ Editorial Board.