Milliken Hand Rehabilitation Center, Washington University School of Medicine, St. Louis, MO.
Division of Plastic and Reconstructive Surgery, Washington University School of Medicine, St. Louis, MO.
J Hand Surg Am. 2022 Jul;47(7):655-661. doi: 10.1016/j.jhsa.2022.03.018. Epub 2022 May 25.
To examine the influence of social deprivation and hand therapy attendance on active range of motion (AROM) outcomes following flexor tendon repair.
We performed a retrospective analysis of patients who underwent primary zone I-III flexor tendon repair between November 2016 and November 2020. Area deprivation index (ADI) was used to quantify social deprivation. Medical record review determined each patient's demographic characteristics, injury details, total hand therapy visits, and final AROM outcome. Active range of motion was converted to Strickland's percentage for analysis. Spearman correlation and simple and multivariable linear regression models were used to assess relationships between explanatory variables and outcomes.
There were a total of 109 patients, with a mean ADI of 53 and mean therapy attendance of 13 visits. Higher ADI and lower therapy attendance were correlated, and each was associated with significantly decreased Strickland's percentage. In the multivariable model, therapy attendance, ADI, zone 2 injury, and age maintained significant associations with Strickland's percentage.
Socially deprived patients attend fewer therapy sessions and obtain poorer AROM after flexor tendon repair. Social deprivation is likely to contribute to poor outcomes both by its association with decreased therapy attendance and by other potential pathways that make it difficult for deprived patients to achieve good surgical outcomes.
TYPE OF STUDY/LEVEL OF EVIDENCE: Prognostic IV.
探讨社会剥夺程度和手部治疗参与度对屈肌腱修复术后主动活动度（AROM）结果的影响。
我们对 2016 年 11 月至 2020 年 11 月期间接受 I-III 区原发性屈肌腱修复的患者进行了回顾性分析。采用地域剥夺指数（ADI）来量化社会剥夺程度。通过病历回顾确定每位患者的人口统计学特征、损伤细节、手部治疗总访视次数以及最终 AROM 结果。将主动活动度转换为 Strickland 百分比进行分析。采用 Spearman 相关分析和简单及多变量线性回归模型来评估解释变量与结果之间的关系。
共纳入 109 例患者，平均 ADI 为 53，平均治疗访视次数为 13 次。较高的 ADI 与较低的治疗参与度相关，且两者均与 Strickland 百分比的显著降低相关。在多变量模型中，治疗参与度、ADI、2 区损伤和年龄与 Strickland 百分比仍保持显著相关性。
社会剥夺程度较高的患者在屈肌腱修复术后接受的治疗次数较少，获得的 AROM 结果也较差。社会剥夺不仅通过与治疗参与度降低相关，还可能通过其他潜在途径导致剥夺程度较高的患者难以获得良好的手术结果，从而对不良结局产生影响。
研究类型/证据水平：预后 IV 级。
