The impact of a hand therapy screening and management clinic for patients referred for surgical opinion in an Australian public hospital.

STUDY DESIGN

Retrospective cohort study.

PURPOSE

To measure the impact of initial treatment by a hand therapist of people referred to a hand surgeon for common hand conditions.

METHODS

This retrospective cohort study included 224 patients with Carpal Tunnel Syndrome, Trigger Finger/Thumb, de Quervain's tenosynovitis, and trapeziometacarpal osteoarthrosis. All were invited to attend for assessment and non-operative treatment and were followed up for at least one year. Between groups comparisons for who attended (N = 164) and those who did not (N = 60) were conducted.

RESULTS

40.8% of the non-operative treatment group and 65% of the no treatment group underwent surgery, which was statistically significant (p = 0.02). Univariate analysis found that the variable "attending non-operative treatment" was able to predict those who did not have surgery (p = 0.02). Multivariate analysis using logistic regression also showed that this was the only significant predictor of not progressing to surgery (p = 0.001).

CONCLUSIONS

Assessment and treatment by a non-operative provider were associated with a decrease in the rate of operative treatment. Prospective, randomized studies could help determine if this observed difference is related to the treatment approach.