Influence of early postoperative worries and expectations on long-term outcomes in hand surgery patients

This retrospective study examines how patients' expectations and their worries about surgical outcomes, worries about ability to work, and worries about quality of life three weeks post-surgery influence long-term outcomes after hand surgery.

We included 396 minor surgery (carpal tunnel surgery, fascia, bursae, tendon sheath, and ganglion cyst surgery) or major surgery (arthrodesis, prosthesis insertion, muscle and tendon surgeries in the hand and wrist) patients. Expectations and worries were assessed 3 weeks postoperatively. Patient-reported outcomes including pain, strength, sensibility, joint motion, and performance were measured 3 and 12 months postoperatively using VAS-scores, Quick-DASH scores.

Overall, 270 (women 56.3%) patients underwent minor surgery and 126 (women 63.5%) underwent major surgery. Both minor and major surgery patients, who were worried three weeks postoperatively, had significantly worse self-rated outcome regarding pain, strength, joint motion, sensibility, and QDASH-scores after 3 and 12 months. In the group of minor surgery patients, the median VAS-scores and QDASH-scores were almost twice as high in the group of worried patients than in the group of not worried patients.

Postoperative expectations and worries correlate with long-term outcomes following hand surgery. Suggesting management of patient expectations and worries early in the postoperative period as a tool to improve long-term functional outcomes in both minor and major hand surgeries.