The post-op hand is swelling, the tendon repair is three days old, and the surgeon wants motion started today — the protocol you choose in the next ten minutes determines whether that finger regains function or stiffens permanently. Standard protocols tell you what to do. They do not tell you what to do when the tissue does not respond, the patient cannot comply, or two competing injuries demand opposite precautions. This book installs a clinical reasoning engine — a five-slot decision architecture applied to every diagnosis in hand therapy — that teaches you to think through the problem rather than look up the answer. INSIDE THIS BOOK • The Rehabilitation Reasoning Engine — a proprietary five-slot framework (Clinical Trigger, Assessment Focus, Protocol Match, Progression Gate, Course Correction) built into every chapter and consolidated in a master compendium • End-feel to orthosis matching — select dynamic, static-progressive, or serial casting based on tissue mechanics, not habit • Nerve regeneration timelines calculated to the millimeter — predict motor recovery windows and trigger tendon transfer referrals before the endplate deadline closes • Tendon, fracture, and nerve protocols layered onto the same digit — manage competing precautions when the operative report lists three repairs • CRPS staged rehabilitation — de-escalate when every instinct says push harder • Burn scar contracture escalation hierarchy — from compression garment through serial casting to surgical release, with defined failure criteria at each level • HTCC exam domain cross-reference — every reasoning block mapped to certification content areas • Pediatric protocol modifications — play-based interventions replacing adult exercise sets for patients who cannot follow verbal instructions Written for occupational therapists, physical therapists, CHT candidates, hand surgery residents, and any clinician who treats the injured upper extremity.
