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The Journal of Hand Therapy a Golden Opportunity
( ____G_U_ES_T_E_D_IT_O_R_IA_L_J
The Journal of Hand Therapy . .. a Golden Opportunity he foundation upon which modern hand surT gery is built is reinforced by the trinity of successful management of the trippled hand-accu-
rate preoperative assessment, skilled surgery and devoted after-care. The 1987 arrival of the Journal of Hand Therapy speaks well for the original purposes, goals and development of the American Society of Hand Therapists that was established in 1977, only one decade ago. This Journal, sponsored by the Society, will further establish the identity of hand therapy as a viable force in the total care of patients with hand injuries and disabilities. The specialty of hand surgery has developed with sufficient depth and breadth to support new concepts and bring them to fruition, such as microsurgery and replantation of severed limbs. New techniques and procedures in hand surgery have broadened our scope of responsibility, further supporting the need for uncompromised postoperative care and methodical documentation and publication of results. Hand centers have developed wherein the team effort of hand surgeons and hand therapists working in close concert supports the evaluation, recording and publishing of results of new techniques in surgery and rehabilitation of the hand and wrist. The impact of hand and upper extremity disorders in American industry is enormous. A study done by hand surgeons and epidemiologists in 1981 demonstrated that approximately one third of all disabling injuries in the United States involve the upper extremity, representing approximately 60 million lost work days annually. In addition, there has been a surprising increase in injuries to the peripheral nerves and wrist secondary to motor vehicle accidents.
Importantly, thorough documentation of the results of these injuries requires the editorial capacity to publish and assist in standardizing new systems of assessment. The Journal of Hand Therapy should become a principal record keeper of these achievements. This is the opportune time for hand therapy and hand surgery to capitalize on a magnificent challenge to develop and support research and study programs necessary to comprehend the biology of recovery following injury and surgery. Programs of controlled movement and gliding must be timed and personalized to the patient and the injury. This concept holds the key to future change, for controlled active and passive motion can alter the biologic state of scar healing, permitting joints to bend, and the suture line of tendons and nerves to glide, while the vital nutrition of repair is stabilized. Carefully considered, this challenge is the Wind in our Face and the Wind of the Future. To sail ahead against the wind and win the race, the skipper must, with a steady hand on the wheel, point and maintain the leading edge of the sail close to the wind. This is called the critical angle of attack. Let the philosophy of the Journal of Hand Therapy, the editorial staff and the authors, plan their critical angle of attack and future challenges carefully. They have an opportunity to change the future course of all our therapeutic efforts. Let this be done with excellence and pride. I know I speak for my colleagues as we extend you support and wish you future success with this important publication. James M. Hunter, M.D.
October-December 1987
5
The Journal of Hand Therapy . .. a Golden Opportunity he foundation upon which modern hand surT gery is built is reinforced by the trinity of successful management of the trippled hand-accu-
rate preoperative assessment, skilled surgery and devoted after-care. The 1987 arrival of the Journal of Hand Therapy speaks well for the original purposes, goals and development of the American Society of Hand Therapists that was established in 1977, only one decade ago. This Journal, sponsored by the Society, will further establish the identity of hand therapy as a viable force in the total care of patients with hand injuries and disabilities. The specialty of hand surgery has developed with sufficient depth and breadth to support new concepts and bring them to fruition, such as microsurgery and replantation of severed limbs. New techniques and procedures in hand surgery have broadened our scope of responsibility, further supporting the need for uncompromised postoperative care and methodical documentation and publication of results. Hand centers have developed wherein the team effort of hand surgeons and hand therapists working in close concert supports the evaluation, recording and publishing of results of new techniques in surgery and rehabilitation of the hand and wrist. The impact of hand and upper extremity disorders in American industry is enormous. A study done by hand surgeons and epidemiologists in 1981 demonstrated that approximately one third of all disabling injuries in the United States involve the upper extremity, representing approximately 60 million lost work days annually. In addition, there has been a surprising increase in injuries to the peripheral nerves and wrist secondary to motor vehicle accidents.
Importantly, thorough documentation of the results of these injuries requires the editorial capacity to publish and assist in standardizing new systems of assessment. The Journal of Hand Therapy should become a principal record keeper of these achievements. This is the opportune time for hand therapy and hand surgery to capitalize on a magnificent challenge to develop and support research and study programs necessary to comprehend the biology of recovery following injury and surgery. Programs of controlled movement and gliding must be timed and personalized to the patient and the injury. This concept holds the key to future change, for controlled active and passive motion can alter the biologic state of scar healing, permitting joints to bend, and the suture line of tendons and nerves to glide, while the vital nutrition of repair is stabilized. Carefully considered, this challenge is the Wind in our Face and the Wind of the Future. To sail ahead against the wind and win the race, the skipper must, with a steady hand on the wheel, point and maintain the leading edge of the sail close to the wind. This is called the critical angle of attack. Let the philosophy of the Journal of Hand Therapy, the editorial staff and the authors, plan their critical angle of attack and future challenges carefully. They have an opportunity to change the future course of all our therapeutic efforts. Let this be done with excellence and pride. I know I speak for my colleagues as we extend you support and wish you future success with this important publication. James M. Hunter, M.D.
October-December 1987
5