The impact of therapy-led hand clinics for the treatment of acute hand injury: A cluster non-randomised controlled trial
In brief
Therapy-led hand clinics cut onward referrals and reduce healthcare contacts
In a cluster trial of 133 adults with acute hand injuries, functional recovery (QuickDASH) was the same at 8 weeks and 6 months whether care was therapist-led or medically led. However, the therapist pathway generated significantly fewer specialist referrals and overall healthcare contacts, indicating a more efficient model that warrants broader implementation.
- Journal
- Clinical rehabilitation (Q1)
- Published
- 17 September 2026
- Study design
- Randomized controlled trial
- Evidence level
- Level 1, High (CEBM 1b)
- Authors
- Margo Sheerin, Rose Galvin, Damien Ryan, Leonora Carey, Eleanor Fallon, Brenda Bleach, et al.
- PMID
- 42752255
- DOI
- 10.1177/02692155261487461
Why clinicians should know about it
- Picked for Emergency Medicine (top studies of the week, 20 September 2026): Therapy‑led hand clinics for acute hand injury, not ED focus
Abstract
PurposeTo evaluate the effectiveness of therapy-led conservative management of acute hand injury in adults when compared to medical-led, care as usual.DesignCluster non-randomised trial.SettingFour intervention sites and one control site, acute hospitals providing emergency care for hand injuries.ParticipantsAdults (18 years +) with acute hand injuries, such as hand fracture, mallet, volar plate and central slip injuries.InterventionThe intervention group had access to therapy-led hand therapy management of their hand injury, compared to care as usual.Main measuresStandardised outcome tools measuring function, health-related quality of life, pain, and occupational value and competence were completed at baseline, 8 weeks and 6 months.ResultsA total of 133 participants were recruited (intervention, n = 67; control, n = 66). Baseline demographics of participants were similar between groups. There was no statistically significant between-group differences in the primary outcome of QuickDASH function at 8 weeks (mean difference -0.05; 95% CI -6.41 to 6.3; p = 0.99) or 6 months (mean difference -1.74; 95% CI -6.35 to 2.87; p = 0.46), or in the secondary outcomes at each time point. However, the difference in scores across time was statistically significant for the primary outcome (p < 0.001), and a number of secondary outcomes. The intervention group had a significantly lower number of onward referrals (p < 0.001) and a reduced number of healthcare contacts.ConclusionNo statistically significant differences were detected between groups on primary or secondary outcomes, suggesting comparable functional recovery between therapy-led and medical-led pathways, while requiring fewer healthcare contacts and onward referrals. Greater utilisation of therapy-led pathways is indicated in the management of hand injury.RegistrationClinicalTrials.gov (NCT06399614).
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.