Surgeon Preference, Influence, and Treatment of Thumb Carpometacarpal Arthritis.
Surgeon Preference, Influence, and Treatment of Thumb Carpometacarpal Arthritis.
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DOI：
10.1177/1558944717717506
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发表时间：
2018-07-01
期刊：
影响因子：
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通讯作者：
Awan, Hisham M
中科院分区：
文献类型：
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作者：
Deutch, Zachary;Niedermeier, Steven R;Awan, Hisham M
背景技术背景：本研究的目的是评估目前的手术实践模式，影响这些模式的因素，在治疗拇指腕掌关节骨性关节炎的整体趋势。方法：一个在线调查，包含14个问题被发送到所有活跃的美国社会的手外科成员。收集人口统计学和治疗信息。结果被匿名上传到一个在线spreadsheets.Results：共823响应记录。使用整个桡侧腕屈肌的斜方肌切除术联合韧带重建和肌腱间置术（LRTI）是最常用的技术，占37.44%。总之，26.38%的经验不足5年的外科医生使用带缝线悬吊（基于骨锚或肌腱）的髂骨切除术; 55.76%的外科医生选择特定手术是因为“个人临床经验”而不是“当前证据”和“培训”。“此外，24.17%的执业时间超过5年的外科医生在过去5年中改变了手术。在美国，97.2%的手外科医生处方羟考酮或氢可酮术后相比，只有23.75%的国际hand surgics.CONCLUSIONS：结果表明，LRTI的腰椎切除术仍然是最流行的治疗选择。使用缝线悬吊的颧骨切除术正在增加，特别是在年轻的外科医生中。与美国手外科医生相比，国际手外科医生更依赖于当前的证据，使用更少的术后治疗和阿片类药物，并且更经常地改变程序。
BACKGROUND: The purpose of this study was to evaluate current surgical practice patterns, the factors that influence these patterns, and overall trends in the treatment of thumb carpometacarpal osteoarthritis.METHODS: An online survey containing 14 questions was sent to all active members of the American Society for Surgery of the Hand. Information on demographics and treatments was collected. Results were anonymously uploaded to an online spreadsheet.RESULTS: A total of 823 responses were recorded. Trapeziectomy with ligament reconstruction and tendon interposition (LRTI) using whole flexor carpi radialis was the most popular technique at 37.44%. In all, 26.38% of surgeons with fewer than 5 years of experience utilize trapeziectomy with suture suspension (bone anchor based or tendon based); 55.76% choose a particular procedure because of "Personal Clinical Experience" over "Current Evidence" and "Training." In addition, 24.17% of surgeons who have been practicing for longer than 5 years have changed procedures in the last 5 years. In the United States, 97.2% of hand surgeons prescribe either oxycodone or hydrocodone postoperatively compared with just 23.75% of international hand surgeons.CONCLUSIONS: The results show that trapeziectomy with LRTI remains the most popular treatment of choice. The use of trapeziectomy with suture suspension is on the rise, particularly in younger surgeons. International hand surgeons rely more on current evidence, utilize less postoperative therapy and opioid medications, and change procedures more often than US hand surgeons.