Taking hold of hand trauma in KwaZulu-Natal, South Africa

BACKGROUND: Trauma in KwaZulu-Natal province in South Africa constitutes at least 17.8% of overall emergency cases, with hand trauma being common. AIM: Based on these statistics, the authors of this study aimed to identify and describe the most common traumatic hand injuries managed in the province including current trends and intervention practices of occupational therapists to inform future intervention. METHODS: Using a mixed-method convergent parallel design, 41 therapists completed an online survey, and 12 therapists participated in two focus group discussions. Survey responses were analysed using descriptive statistics, and the audio-recorded and transcribed focus group discussions were analysed deductively using thematic analysis. FINDINGS: Flexor tendon injuries (88%), extensor tendon injuries (73%), fractures (83%) and combined hand injuries (73%) were the most common injuries noted. Sufficient theoretical knowledge (95%), clinical judgement (93%), available resources (88%), relevant practical experience (83%) and surgeon hand therapy protocols (88%) were identified as essential in managing traumatic hand injuries. Challenges included having limited resources, late referrals and poor communication hindering multidisciplinary practice. CONCLUSION: Therapists face challenges in managing traumatic hand injuries, which inhibits optimal intervention planning. These factors may inevitably negatively influence outcomes achieved through occupational therapy for this group of patients.