Variations in Postoperative Immobilization Following Common Hand Surgery Procedures

Abstract

Background:The aim was to investigate variations in the duration of postoperative immobilization for common hand surgery procedures and to determine whether there is any correlation between surgeon experience and duration of postoperative immobilization. Methods: An anonymous cross-sectional survey was sent to the American Society for Surgery of the Hand asking the following questions: (1) number of years in practice and (2) duration of immobilization for 16 common hand surgery procedures. A Pearson's correlation coefficient was used to determine correlations between surgeon experience and duration of immobilization. Box plots were created to display the distribution and variability in postoperative immobilization per procedure among surgeons. Results: A total of 1126 respondents completed the survey, yielding a response rate of 40%. Procedures with a greater average duration of immobilization demonstrated the greatest variability. The largest variability overall was observed in intercarpal ligament repair with the majority of responses distributed between 4 and 10 weeks of immobilization. The smallest variability was observed following De Quervain's release and Dupuytren's fasciectomy. Only small correlations between surgeon experience and duration of immobilization were observed. Specifically, all Pearson correlation coefficients were less than .20. Conclusions: This study supports the hypothesis that large variations exist in the duration of immobilization following common hand surgery procedures. Only small correlations were found between surgeon experience and average duration of immobilization. The study suggests that there is a lack of evidence to guide postoperative immobilization for common hand surgery procedures and that prolonged immobilization may not be necessary for certain hand procedures.

Patient-Reported Outcomes After Surgical Treatment of Early Osteoarthritis of the First Carpometacarpal Joint

“…However, this response rate is in line with other long-term follow-up hand surgery studies using similar methodology. [21][22][23] In addition, there may be selection bias as we observed more nonmanual laborers in the responding cohort. We defined the follow-up time as the time from surgery to last clinical visit recorded in medical charts considering that this would minimize the loss of follow-up from patients who switched hospitals within our institutional system.…”