Rehabilitation of the Hand and Upper Extremity Volume 1

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PREFACE
Synergy, in general, may be defined as two or more agents working together to produce a result not obtainable by any of the agents independently. Synergy is the ability of a group to outperform even its best individual member. The sixth edition of Rehabilitation of the Hand and Upper Extremity is the product of the synergy of editors, authors, publishers and many others involved in its publication.

The impetus for the first edition of Rehabilitation of the Hand grew out of a unique symposium that featured hand surgery correlated with hand therapy, sponsored by the Hand Rehabilitation Foundation in Philadelphia in 1976. The original editors of the book were also the chairpersons and faculty for the symposium: James M. Hunter, MD; Lawrence Schneider; Evelyn Mackin, PT; and Judith A. Bell Krotoski, OTR, FAOTA, CHT. Joining the effort with the second through fifth editions was Anne D. Callahan, MS, OTR/L, CHT. These extraordinary individuals introduced a working partnership of hand surgeons and hand therapists for the care of the hand patient that has endured and flourished over the years and is evidenced by the publication of the sixth edition of this book.

The expansion of this text and its readership is in keeping with the growth of the specialty of hand rehabilitation. This current two-volume edition features a total of 143 chapters, 37 of which are new, and more than 75 new authors. The authors of the text include physical and occupational therapists, certified hand therapists, orthopedic and plastic surgeons, physiatrists, neurologists, psychologists, psychiatrists, clinicians, researchers, and educators—all having expertise in the care of the hand and upper extremity patient.

Since the first edition, the table of contents has expanded with each edition to include separate sections on the shoulder, elbow, and wrist, as well as the hand. Many returning sections have been modified and expanded to reflect current practice. For example, the term orthosis is used to refer to the custom fabricated devices typically referred to as splints. Far from just a technical skill, the design and fabrication of hand and upper extremity orthoses require an in-depth knowledge of anatomy and pathology, as well as the healing and positioning requirements for the range of conditions and surgeries encountered. Hand, occupational, and physical therapists are uniquely qualified to design, apply, monitor, and modify orthotic devices as part of the rehabilitation treatment plan.
Taking advantage of the advances in information technology, this edition is complemented by a companion web site allowing supplemental information and video clips of therapy and surgery procedures to be included.

Given the emphasis on evidence-based practice in the current healthcare environment, special focus has been placed on providing peer-reviewed literature support for the information given in this text. However, published research in hand and upper extremity rehabilitation is limited in many areas. In some cases the best evidence is the clinical experience of the individual authors. Where it is stated that no evidence exists to support a particular approach or technique, the intention is not to suggest that it be abandoned; rather the goal is to stimulate the reader to adopt a critical attitude and to pursue clinical research, whether as a single case study or a multicenter randomized controlled trial.

We have dedicated this edition to Evelyn Mackin, who has been the driving force behind the book, as well as so many other groundbreaking achievements. Her leadership, dedication, determination, and inspiration have been instrumental in advancing the specialty of hand rehabilitation, as well as inspiring countless others (including the current editors) to follow her lead and further her initiatives. Available on the book’s web site is a fascinating interview with Evelyn, recounting the early days of hand therapy, the formation of the American Society of Hand Therapists, the development of the Journal of Hand Therapy, and many other aspects of her extraordinary career.

The publication of the sixth edition of Rehabilitation of the Hand and Upper Extremity is the result of the efforts of many people over more than 3 years and acknowledgments are due. First and foremost, we would like to thank all of the authors who have contributed their clinical expertise and insights to this text.

Our special thanks is extended to Evelyn Mackin, who has written the foreword for this edition and who has provided guidance, support, and encouragement to the current editors.

We would like to acknowledge our editors at Elsevier for their ongoing support and persistence to see the text through to publication. In particular, Lucia Gunzel has been the perfect combination of coach, cheerleader, and disciplinarian. With Dan Pepper’s diplomacy and wise counsel, rough patches were navigated and resolved. Ellen Sklar deserves

recognition for her professional management of the final stages of the editing process, a daunting task.

Thanks to Leslie Ristine, Administrator of the Philadelphia Hand Rehabilitation Foundation, for providing administrative support, and to Andrew Cooney, Executive Director of the Philadelphia and South Jersey Hand Centers, who has provided encouragement and support during the work on the sixth edition, as well as for prior editions.

Finally, we thank our families, friends, and colleagues who have provided encouragement and patience during the 3 years that it has taken to complete the book.
We are proud to present this sixth edition of Rehabilitation of the Hand and Upper Extremity.