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Healing II: Complications01:24

Healing II: Complications

Complications during healing arise when tissue repair is altered by local or systemic factors. These changes involve abnormal collagen deposition, altered biomechanics, and reduced vascular supply, impairing restoration of normal structure and function.Loss of FunctionScar tissue differs significantly from the original tissue it replaces. In the skin, fibrosis lacks adnexal structures such as hair follicles, sebaceous glands, and sweat glands. Their absence reduces tactile sensitivity, impairs...

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Loss to Follow-up After Tendon Repair: Impact on Functional Recovery.

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Patients lost to follow-up (LTFU) after hand tendon repair show worse outcomes. Early dropout from therapy may compromise recovery, highlighting the need to address adherence barriers for better functional status.

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Area of Science:

  • Orthopedic Surgery
  • Rehabilitation Medicine
  • Hand Therapy

Background:

  • Adherence to hand therapy post-flexor and extensor tendon repair is crucial but variable.
  • Patients lost to follow-up (LTFU) present a challenge in assessing functional outcomes.
  • Previous research identified LTFU predictors but not their functional status.

Purpose of the Study:

  • To evaluate if patients LTFU achieve comparable functional outcomes compared to therapy completers.
  • To assess functional status using QuickDASH and Patient-Rated Wrist and Hand Evaluation (PRWHE) scores in LTFU patients versus completers.

Main Methods:

  • Retrospective chart review of 268 patients undergoing tendon repair.
  • Collected PRWHE, QuickDASH scores, and therapy session attendance.
  • Compared functional scores at discharge/last visit between therapy completers and LTFU patients.

Main Results:

  • LTFU rate was 38%; these patients had significantly worse final PRWHE scores (42.82 vs 24.47).
  • LTFU patients showed lower overall PRWHE improvement (30.02 vs 46.9) and pain subscore changes.
  • No significant difference in QuickDASH scores was observed between groups.

Conclusions:

  • Worse PRWHE scores in LTFU patients suggest early dropout compromises recovery.
  • Visit count showed limited predictive value for functional improvement.
  • Addressing barriers to therapy adherence is essential to improve patient outcomes.