TY - JOUR
T1 - The epidemiology of reoperation after flexor pulley reconstruction
AU - Dy, Christopher J.
AU - Lyman, Stephen
AU - Schreiber, Joseph J.
AU - Do, Huong T.
AU - Daluiski, Aaron
N1 - Funding Information:
This research was funded by the National Institute of Arthritis and Musculoskeletal and Skin Diseases grant T32-AR07281 (to C.J.D.) and the Agency for Healthcare Research and Quality grant U18-HS16075 (to S.L.).
PY - 2013/9
Y1 - 2013/9
N2 - Purpose: We used a statewide database to determine the incidence of pulley reconstruction and to evaluate the influence of demographics on reoperation. We hypothesized that age, insurance status, and concomitant nerve or tendon procedure would influence the likelihood of reoperation. Methods: We used the Statewide Planning and Research Cooperative System ambulatory surgery database from New York, which represents all outpatient surgery in the state. Patients who had flexor pulley reconstruction from 1998 to 2009 were identified using Current Procedural Terminology 4 codes. Subsequent surgery records for these patients were identified through 2010, allowing at least 1 year follow-up. Concomitant nerve procedure and flexor tendon repair/reconstruction were identified. The type and timing of subsequent procedures, including tenolysis and repeat pulley reconstruction, were recorded. Univariate statistics were calculated to compare age, sex, and payer type between patients with and without reoperation. A multivariable, logistic regression model was used to evaluate the association of the demographics with the chances of having reoperation. Results: There were 623 patients who had flexor pulley reconstruction from 1998 to 2009. The incidence of pulley reconstruction was 0.27 per 100,000 persons, with an annual frequency of 52 procedures. There were 39 (6%) reoperations. There was no difference in age, concomitant nerve or tendon repair, or workers' compensation between patients with and without reoperation. Regression modeling showed a higher likelihood among men of having reoperation. Conclusions: Flexor pulley reconstructions are rare. One-quarter of surgeons performed only one flexor pulley reconstruction over a 12-year period. The 6% reoperation rate is similar to our previous findings for flexor tendon repair using similar methodology. Our report provides information that may be useful in counseling patients. Type of study/level of evidence: Prognostic II.
AB - Purpose: We used a statewide database to determine the incidence of pulley reconstruction and to evaluate the influence of demographics on reoperation. We hypothesized that age, insurance status, and concomitant nerve or tendon procedure would influence the likelihood of reoperation. Methods: We used the Statewide Planning and Research Cooperative System ambulatory surgery database from New York, which represents all outpatient surgery in the state. Patients who had flexor pulley reconstruction from 1998 to 2009 were identified using Current Procedural Terminology 4 codes. Subsequent surgery records for these patients were identified through 2010, allowing at least 1 year follow-up. Concomitant nerve procedure and flexor tendon repair/reconstruction were identified. The type and timing of subsequent procedures, including tenolysis and repeat pulley reconstruction, were recorded. Univariate statistics were calculated to compare age, sex, and payer type between patients with and without reoperation. A multivariable, logistic regression model was used to evaluate the association of the demographics with the chances of having reoperation. Results: There were 623 patients who had flexor pulley reconstruction from 1998 to 2009. The incidence of pulley reconstruction was 0.27 per 100,000 persons, with an annual frequency of 52 procedures. There were 39 (6%) reoperations. There was no difference in age, concomitant nerve or tendon repair, or workers' compensation between patients with and without reoperation. Regression modeling showed a higher likelihood among men of having reoperation. Conclusions: Flexor pulley reconstructions are rare. One-quarter of surgeons performed only one flexor pulley reconstruction over a 12-year period. The 6% reoperation rate is similar to our previous findings for flexor tendon repair using similar methodology. Our report provides information that may be useful in counseling patients. Type of study/level of evidence: Prognostic II.
KW - epidemiology
KW - flexor pulley
KW - outcomes
KW - socioeconomic
UR - http://www.scopus.com/inward/record.url?scp=84883138169&partnerID=8YFLogxK
U2 - 10.1016/j.jhsa.2013.05.015
DO - 10.1016/j.jhsa.2013.05.015
M3 - Article
C2 - 23845587
AN - SCOPUS:84883138169
SN - 0363-5023
VL - 38
SP - 1705
EP - 1711
JO - Journal of Hand Surgery
JF - Journal of Hand Surgery
IS - 9
ER -