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.