From the Editor's Desk

H and Therapy has an expanded archive of back issues available on-line and dating back to 2001 – this means that almost 10 years worth of issues can now be accessed as full text on-line. Furthermore the facility of ‘on-line first’ has now gone live, which means that as soon as articles are accepted and corrected proofs approved these are available on-line and ahead of print. Both of these developments have been made possible by generous support from the European Federation of Societies for Hand Therapy and the British Association of Hand Therapists.

This is the last issue of 2010 and I would like to take this opportunity to thank our authors, reviewers, editorial board members and staff at RSMP for their hard work and ongoing support for Hand Therapy.

The first paper by Naser Mohammed Alotaibi from Kuwait describes the cross-cultural adaptation and pilot testing of the Arabic version of the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire. This region-specific, patient-rated outcome measure has now been translated into 27 languages with a further 11 translations in progress (www.dash.iwh.on.ca – last accessed 6 November 2010). His work highlights the extensive process required not only to provide a linguistic translation but also to ensure that the items are culturally relevant and appropriate while maintaining equivalence with the original instrument.

Angela Toemen and Robyn Midgley from London present their work on the development of an evidence-based patient pathway for management of metacarpal fractures of the hand. Following a review of existing literature, the authors propose a new algorithm for management of metacarpal fractures according to site and fracture type, which aims to minimize complications and make more efficient use of resources such as therapy appointments. They conclude that some fractures can be managed more ‘aggressively’ avoiding unnecessary and lengthy immobilization and minimizing work absence. The next step would be to evaluate the efficacy and cost-effectiveness of this new pathway against existing pathways.

The third paper by author Emily Ho from Toronto discusses the orthotic provision for children with obstetric brachial plexus palsy. Using biomechanical and developmental theory, she proposes a clinical decision-making algorithm for children at different developmental stages, which carefully balances the risks and benefits of orthotics.

Finally, David Warwick and colleagues from Southampton present an audit of a multidisciplinary Dupuytren's clinic. They describe the complimentary role that hand therapists and different surgery staff grades can play to provide an efficient management pathway from referral to discharge. The audit demonstrates that a condition-specific clinic like this can minimize waiting times for patients and ensures better use of resources.