Our Summary

This research paper is about measuring the outcomes of elective hand surgeries. In the past, outcome measures were often centered around what the surgeon observed and reported. However, these measures often didn’t align with the patient’s actual hand function or what was important to the patient. Therefore, there’s been a shift towards using patient-reported outcome measures (PROMs), which are basically feedback from patients about their health condition and its impact on their lives.

The researchers conducted a systematic review to see what kind of PROMs were being used in studies on elective hand surgeries. They found that there were a variety of PROMs being used, with some focusing on specific diseases, some on specific sites on the body, and some on general quality of life. Among all these, the most commonly used PROM was the Disabilities of the Arm, Shoulder and Hand (DASH) measure. They also found that site-specific PROMs have been more popular since the year 2000.

However, the researchers found that there is no clear consensus on which PROMs should be used. They suggest that a systematic evaluation of the different PROMs might help standardize measurement in the future.

FAQs

  1. What are patient-reported outcome measures (PROMs) in the context of elective hand surgeries?
  2. What was the most commonly used PROM in studies on elective hand surgeries according to the research?
  3. Why did the researchers suggest a systematic evaluation of the different PROMs used in hand surgery?

Doctor’s Tip

One helpful tip a doctor might give a patient about hand surgery is to actively participate in providing feedback through patient-reported outcome measures. By sharing your experiences and the impact of the surgery on your daily life, you can help your healthcare team better understand your progress and tailor your treatment plan accordingly. This can ultimately lead to improved outcomes and a more personalized approach to your care.

Suitable For

Patients who are typically recommended for hand surgery are those who have conditions or injuries that are affecting their hand function and quality of life. This can include individuals with:

  1. Carpal tunnel syndrome
  2. Trigger finger
  3. Dupuytren’s contracture
  4. Arthritis in the hand or wrist
  5. Tendon or nerve injuries
  6. Fractures or dislocations in the hand or wrist

These patients may experience symptoms such as pain, stiffness, weakness, numbness, or limited range of motion in their hands, which can significantly impact their ability to perform daily activities and tasks. Hand surgery may be recommended to alleviate these symptoms, improve hand function, and enhance overall quality of life for these patients.

Timeline

Before hand surgery, a patient typically experiences pain, limited range of motion, and difficulty performing daily activities due to their hand condition. They may consult with a hand surgeon to discuss their options and decide on a surgical plan. The patient will undergo pre-operative assessments, such as physical exams, imaging tests, and blood work, to ensure they are a suitable candidate for surgery.

After hand surgery, the patient will experience post-operative pain, swelling, and stiffness in the hand. They will need to follow a rehabilitation program, which may include physical therapy, occupational therapy, and home exercises, to regain strength and function in the hand. The patient will attend follow-up appointments with their surgeon to monitor their progress and address any concerns.

Throughout this process, the patient’s experience and outcomes are important to consider. Using PROMs, such as the DASH measure, can help assess the effectiveness of the surgery in improving the patient’s hand function and quality of life. By collecting feedback directly from patients, healthcare providers can better understand the impact of elective hand surgeries and tailor their treatment plans to meet the individual needs of each patient.

What to Ask Your Doctor

Some questions a patient should ask their doctor about hand surgery include:

  1. What specific type of hand surgery do you recommend for my condition?
  2. What are the potential risks and complications associated with the surgery?
  3. What is the expected recovery time and rehabilitation process after the surgery?
  4. How will the surgery impact my hand function and quality of life?
  5. What are the expected outcomes of the surgery in terms of pain relief and improved hand function?
  6. Will I need any additional treatments or therapy after the surgery?
  7. Are there any alternative treatment options to consider before proceeding with surgery?
  8. How many times have you performed this type of surgery, and what is your success rate?
  9. Can you provide me with information on patient-reported outcome measures to help me understand the potential outcomes of the surgery?
  10. Can you connect me with any past patients who have undergone similar surgeries, so I can hear about their experiences and outcomes?

Reference

Authors: Lloyd-Hughes H, Geoghegan L, Rodrigues J, Peters M, Beard D, Price A, Jain A. Journal: J Hand Surg Asian Pac Vol. 2019 Sep;24(3):329-341. doi: 10.1142/S2424835519500425. PMID: 31438799