Patient-Rated Wrist Evaluation Threshold for Successful Open Surgery of the Triangular Fibrocartilage Complex.

 To determine thresholds in patient-reported outcome measures at baseline in patients electing to undergo triangular fibrocartilage complex (TFCC) surgery to select patients with clinically improved outcomes.  The study cohort comprised consecutive patients who underwent open TFCC repair between December 2011 and December 2018 in various clinics in the Netherlands. All patients were asked to complete the patient-rated wrist evaluation (PRWE) questionnaire at baseline as well as at 12 months postoperatively.

Surgical Techniques in Nontraumatic Midcarpal Instability: Evaluating the Dorsal Capsulodesis and 3-Ligament Tenodesis Technique.

Background: Surgical management of midcarpal instability (MCI), also referred to as carpal instability nondissociative, remains controversial because of limited evidence on different techniques. This study aimed to assess and compare differences in patient-reported pain, hand and wrist function, satisfaction, range of motion, and return to work in patients with nontraumatic MCI who underwent surgical treatment either through dorsal wrist capsulodesis or 3-ligament tenodesis (3LT).

Methods: Patients with MCI and persisting complaints after conservative therapy treated with 3LT or dorsal capsulodesis were included.

Reconstruction of an Early-Stage Scapholunate Advanced Collapse Wrist with the 3-Ligament Tenodesis Procedure: A Controversial Reappraisal.

Background: The authors hypothesized that the 3-ligament tenodesis (3-LT) procedure is still sufficient-even in scapholunate advanced collapse (SLAC) cases-to reduce pain and improve wrist function. The authors compared patient-reported outcomes of scapholunate interosseus ligament (SLIL) injury patients with SLAC, to SLIL injury patients treated with 3-LT, and then to patients who underwent proximal row carpectomy (PRC), as a control group.

Methods: The authors included all patients with a traumatic SLIL injury and associated SLAC components treated with 3-LT and completed patient-rated wrist evaluation (PRWE) questionnaires preoperatively and at 12-month follow-up.

Outcomes of an exercise program in patients with dorsal or volar midcarpal laxity: a cohort study of 213 patients.

Purpose: Describing the outcomes of an exercise program on wrist and hand function for patients with midcarpal instability (MCI).

Materials And Methods: This study has a prospective cohort design. Two hundred and thirteen patients with MCI were included.

Comparing Patient-Reported Outcomes on Three-Ligament Tenodesis Between Partial and Complete Scapholunate Ligament Injuries: A Cohort Study.

Purpose: Multiple studies report outcomes after 3-ligament tenodesis (3-LT) in treating traumatic scapholunate interosseous ligament injury (SLIL). However, investigators do not differentiate between patients with partial or complete SLIL injury. The relation between the extent of SLIL disruption and surgical outcomes and if this should be considered when treating a patient with SLIL injury remains unknown.

Routinely-Collected Outcomes of Proximal Row Carpectomy.

Purpose: To describe patient-reported pain and function 12 months after proximal row carpectomy (PRC). Secondary outcomes included return to work, grip strength, range of wrist motion, satisfaction with treatment results, and complications.

Methods: This cohort study was part of the British Society for Surgery of the Hand Studyathon 2021, using ongoing routinely-collected data of 304 eligible patients who underwent PRC (73% scapholunate advanced collapse, 11% scaphoid nonunion advanced collapse wrist; 11% Kienböck, 5% other indications) from Xpert Clinics, the Netherlands between 2012-2020.

Involvement in a Personal Injury Claim Is Associated With More Pain and Delayed Return to Work After Elective Nonsurgical or Surgical Treatment for Hand or Wrist Disorders: A Propensity Score-matched Comparative Study.

Background: A small proportion of patients treated for a hand or wrist condition are also involved in a personal injury claim that may or may not be related to the reason for seeking treatment. There are already indications that patients involved in a personal injury claim have more severe symptoms preoperatively and worse surgical outcomes. However, for nonsurgical treatment, it is unknown whether involvement in a personal injury claim affects treatment outcomes.

Biomechanical Outcomes of Surgically Repaired TFCC Palmer Type 1B Tears: A Systematic Review of Cadaver Studies.

Background: Palmer type 1B triangular fibrocartilage complex (TFCC) tears are a common cause of distal radioulnar joint (DRUJ) instability. Unfortunately, the best surgical technique for TFCC reinsertion is still unknown, and up to a quarter of patients report instability after repair. The purpose of this systematic review of cadaver studies was to compare the biomechanical outcomes of different surgical techniques used for Palmer 1B TFCC tears.

Prognostic Factors in Open Triangular Fibrocartilage Complex (TFCC) Repair.

Purpose: Patients with triangular fibrocartilage complex (TFCC) injury report ulnar-sided wrist pain and impaired function. Open TFCC repair aims to improve the condition of these patients. Patients have shown reduction in pain and improvement in function at 12 months after surgery; however, results are highly variable.

Predicting complete finger extension in Dupuytren's disease.

Multiple studies have reported the effectiveness of treatment on contracture reduction in Dupuytren's disease. However, very few studies have attempted to quantify to which extent patient and disease characteristics influence the chance of achieving a straight finger after surgery. Therefore, the aim of this study is to explore to which extent pre-operative patient and disease characteristics can reliably predict a straight finger after surgery for Dupuytren's disease.

Collaborative hand surgery clinical research without sharing individual patient data; proof of principle study.

High-quality research in hand surgery is increasingly important. A vital component is national and international multicenter collaborative research because of better generalizability and larger sample sizes. However, sharing patient data between centers can be hampered by regulations and privacy issues or reluctance to share patient data.

The impact of psychosocial variables on initial presentation and surgical outcome for ulnar-sided wrist pathology: a cohort study with 1-year follow-up.

Aims: Ulnar-sided wrist pain has historically been equated to lower-back pain of wrist surgery. Little is known about the relationship between psychosocial profile and the manifestation of ulnar-sided wrist pathology and their treatment outcomes. This study aimed to determine the impact of pain catastrophising, psychological distress, illness perception, and patients' outcome expectations on patient-reported pain and hand function before and one year after surgery for ulnar-sided wrist pathology.

What Are the Minimally Important Changes of Four Commonly Used Patient-reported Outcome Measures for 36 Hand and Wrist Condition-Treatment Combinations?

Background: Patient-reported outcome measures (PROMs) are frequently used to assess treatment outcomes for hand and wrist conditions. To adequately interpret these outcomes, it is important to determine whether a statistically significant change is also clinically relevant. For this purpose, the minimally important change (MIC) was developed, representing the minimal within-person change in outcome that patients perceive as a beneficial treatment effect.

Return to Usual Work Following an Ulnar Shortening Osteotomy: A Sample of 111 Patients.

Purpose: The primary aim of this study was to analyze the median time until patients performed their usual work following an ulnar shortening osteotomy (USO). The secondary aim was to identify factors influencing the median time until return to their usual work.

Methods: We used a retrospective cohort of patients with ongoing data collection from our institution in the Netherlands.

Return to Work and Associated Costs after Treatment for Dupuytren's Disease.

Background: Return to work is potentially an important factor in assessing the success of treatment. However, little is known about the return to work after treatment for Dupuytren's contracture. Therefore, the primary aim of this study was to assess return to work after limited fasciectomy and percutaneous needle fasciotomy.

Closing the loop: a 10-year experience with routine outcome measurements to improve treatment in hand surgery.

Routine outcome measurements as a critical prerequisite of value-based healthcare have received considerable attention recently. There has been less attention for the last step in value-based healthcare where measurement of outcomes also leads to improvement in the quality of care. This is probably not without reason, since the last part of the learning cycle: 'Closing the loop', seems the hardest to implement.

Are Patient Expectations and Illness Perception Associated with Patient-reported Outcomes from Surgical Decompression in de Quervain's Tenosynovitis?

Background: Psychological factors such as depression, pain catastrophizing, kinesiophobia, pain anxiety, and more negative illness perceptions are associated with worse pain and function in patients at the start of treatment for de Quervain's tenosynovitis. Longitudinal studies have found symptoms of depression and pain catastrophizing at baseline were associated with worse pain after treatment. It is important to study patients opting for surgery for their condition because patients should choose surgical treatment based on their values rather than misconceptions.

Factors associated with return to work after open reinsertion of the triangular fibrocartilage.

The aim of this study was to assess return to work (RTW) after open Triangular Fibrocartilage Complex (TFCC) reinsertion. RTW after open surgery for TFCC injury was assessed by questionnaires at 6 weeks, 3 months, 6 months, and 12 months post-operatively. Median RTW time was assessed on inverted Kaplan-Meier curves and hazard ratios were calculated with Cox regression models.

Patient-reported outcomes and function after reinsertion of the triangular fibrocartilage complex by open surgery.

Aims: Patients with a triangular fibrocartilage complex (TFCC) injury report ulnar-sided wrist pain and impaired function. The surgical procedure of TFCC reinsertion aims to improve function in patients with this injury in whom conservative treatment has failed. The purpose of this study was to investigate the outcomes of open TFCC reinsertion.

Factors affecting return to work after surgical treatment of trapeziometacarpal joint osteoarthritis.

This study aimed to identify factors contributing to the timing of return to work after surgical treatment of trapeziometacarpal joint osteoarthritis and to calculate the costs of lost productivity. We included 627 patients with paid employment who underwent trapeziectomy and ligament reconstruction with tendon interposition. Time to return to work was measured through filling online questionnaires and analysed using survival analysis at 6 weeks and 3, 6 and 12 months after the surgery.

Routine Health Outcome Measurement: Development, Design, and Implementation of the Hand and Wrist Cohort.

Routine measurement of outcome of clinical care is increasingly considered important, but implementation in practice is challenging. This article describes (1) how the authors created and implemented a routine outcome measurement cohort of patients with hand and wrist conditions and (2) how these data are used to improve the quality of care and facilitate scientific research. Starting in 2011, routine outcome measurement was implemented at all practice sites (currently 22) of a specialized treatment center for hand and wrist conditions across The Netherlands.

Illness Perceptions of Patients With First Carpometacarpal Osteoarthritis, Carpal Tunnel Syndrome, Dupuytren Contracture, or Trigger Finger.

Purpose: Previous studies indicate that patients with a more negative perception of their illness tend to respond less favorably to treatment, but little is known about whether illness perceptions differ based on the type of hand or wrist conditions. Therefore, we compared illness perceptions between patients scheduled to undergo surgery for 4 illnesses in hand surgery: carpometacarpal osteoarthritis (CMC OA), Dupuytren disease, carpal tunnel syndrome (CTS), and trigger finger syndrome (TFS). We hypothesized there would be differences in illness perception between these patient groups.