Barret Patrick C, Hackley Darren T, Lockhart Ellen S, Yu-Shan Andrea A, Bravo Cesar J, Apel Peter J
Virginia Tech Carilion School of Medicine, Roanoke, USA.
Institute for Orthopaedics and Neurosciences, Carilion Clinic, Roanoke, VA, USA.
Hand (N Y). 2025 Jan;20(1):129-135. doi: 10.1177/15589447231188454. Epub 2023 Aug 14.
The purpose of this study was to gather information regarding current practices in the care of carpometacarpal (CMC) arthroplasty including the use of hand therapy, immobilization, and surgical technique, and to determine which factors influence these patterns.
We conducted a survey from February 24, 2022, through March 26, 2022, of 3648 currently practicing members of the American Society for Surgery of the Hand. We developed an 11-item questionnaire that contained questions about surgical technique, immobilization, and postoperative therapy utilization. Results were analyzed using chi-square analysis and a Bonferroni correction was applied to account for multiple comparisons. Statistical significance was set at a -value of less than .05.
A total of 811 hand surgeons completed the survey (22% response rate). Surgeons who are employed by the same medical center as their hand therapist use more in-person hand therapy than surgeons with other types of business relationships. Surgeons with more than 25 years of experience are less likely to recommend therapy routinely, more likely to use ligament reconstruction and tendon interposition, and less likely to be an employee of the same medical center as their hand therapist. The length of immobilization and the time at which hand therapy began were related to surgical technique.
Variability in hand therapy usage after CMC arthroplasty is at least partially explained by business relationships with hand therapists and surgeon experience. Variability in the length of immobilization and the beginning of hand therapy postoperatively was more associated with surgical technique.
本研究的目的是收集有关腕掌关节（CMC）置换术当前护理实践的信息，包括手部治疗、固定和手术技术的使用情况，并确定哪些因素会影响这些模式。
我们在2022年2月24日至2022年3月26日期间对3648名美国手外科协会的在职会员进行了一项调查。我们设计了一份包含11个项目的问卷，其中包含有关手术技术、固定和术后治疗利用情况的问题。使用卡方分析对结果进行分析，并应用Bonferroni校正来处理多重比较。统计学显著性设定为p值小于0.05。
共有811名手外科医生完成了调查（回复率为22%）。与手部治疗师受雇于同一医疗中心的外科医生比具有其他业务关系类型的外科医生更多地使用面对面手部治疗。经验超过25年的外科医生不太可能常规推荐治疗，更有可能使用韧带重建和肌腱植入，并且不太可能与他们的手部治疗师受雇于同一医疗中心。固定时间的长短和手部治疗开始的时间与手术技术有关。
CMC置换术后手部治疗使用的差异至少部分可以通过与手部治疗师的业务关系和外科医生的经验来解释。固定时间长短和术后手部治疗开始时间的差异与手术技术的关联更大。
