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Hand Therapy after Flexor and Extensor Tendon Repair: Assessing Predictors of Loss to Follow-up
Desmond J Bennett1, Jugert Bango2, Douglas M Rothkopf1
1Division of Plastic Surgery, University of Massachusetts Medical School, Worcester, Mass.
Plastic and Reconstructive Surgery. Global Open
|May 1, 2023
Summary
Younger age, male gender, lower education, and psychiatric history predict loss to follow-up (LTFU) in hand tendon repair patients. Identifying these factors aids in developing strategies to reduce attrition and improve patient outcomes.
Area of Science:
- Orthopedics
- Hand Surgery
- Rehabilitation Medicine
Background:
- Postoperative hand therapy (HT) is crucial for functional recovery after hand and wrist tendon repair.
- Loss to follow-up (LTFU) is a significant barrier to successful rehabilitation and complication prevention.
Purpose of the Study:
- To identify demographic and clinical factors predicting attrition in patients undergoing hand and wrist tendon repair.
- To inform targeted interventions for high-risk patient populations to improve adherence to hand therapy.
Main Methods:
- Retrospective chart review of 149 patients undergoing extensor or flexor tendon repair (2014-2019).
- Analysis of demographic data (age, sex, education, employment, insurance, zip code) and LTFU rates.
- Logistic regression used to determine predictors of attrition.
Main Results:
- Overall LTFU rate was 42%.
- Predictors of LTFU included younger age, male gender, lower educational attainment, and a history of psychiatric illness.
- Employment status, insurance type, and distance to HT center did not predict attrition.
Conclusions:
- Demographic factors significantly influence attrition in patients undergoing distal upper extremity tendon repair.
- Younger, less educated males with psychiatric histories are at higher risk for LTFU.
- Identifying at-risk patients allows for tailored strategies to enhance hand therapy adherence and improve outcomes.
