Tips and Tricks

Discussion to explore nontraditional techniques for contracture management within degenerative muscle conditions, such as muscular dystrophy. Interventions to be discussed include serial casting, splinting, and passive stretching with the goal of improving functional positioning and hygiene support for caregivers.

Best practice for flexor tendon rehabilitation for older children and adults is well established, but a gap exists between this, and the interventions used for young children. This session explores the feasibility of an innovative approach to treating flexor tendon repairs for young children based on the principles of early mobilization. The use of early mobilization flexor tendon rehabilitation protocols is the gold-standard in adult hand therapy. Currently, there is low level evidence in support of flexor tendon repair rehabilitation for pediatric patients. The evidence suggests that children have limited complications and good functional outcomes; however, these results include various protocols and demographics. In clinical practice, immobilization protocols used with the youngest children are in question because of the sequalae of clinical challenges observed, including, tendon adhesions and joint stiffness which limit the movement needed for developmental grasp patterns. The proposed protocol allows for controlled active and passive motion beginning within one week of surgery and follows a well understood progression used in adult hand therapy, modified to meet the needs of young children. Using a case study format, speakers share a novel orthosis design that provides both safe immobilization and controlled active motion. Clinical pearls and pitfalls will be reflected upon to promote clinical reasoning.

Pediatric tendon repairs demand precise splinting, strict precautions, and intensive therapy–yet many families leave visits unsure what to do next. This session shows how a multidisciplinary hand team partnered with a health literacy department to co‑create clear, consistent pre‑ and post‑operative education for children with zone II—V flexor tendon repairs and their caregivers. You will see how standardized, plain‑language materials, visual supports, and the teach‑back method were built into real‑world clinic and therapy workflows, and how a six‑patient pilot suggests effects on adherence, complications, and motion outcomes. This presentation provides examples of how to support families understand and carry out postoperative protocols.