Table 2.
Hand surgical diagnoses and treatmentsa
| Diagnostic categories | Treatments | n | Conservatively treated, % | Operatively treated, % |
|---|---|---|---|---|
| Acute soft tissue trauma, open | Repair, reconstruction, and special wound dressingb | 7 | 3.0 | 6.1 |
| Acute complex | Repair, reconstruction of at least 3 injured | 7 | 0.0 | 7.1 |
| trauma, open | structures (i.e., skin, tendon, bone, joint, and vessel) | |||
| Acute complex trauma with nerve injury, open | Repair, reconstruction of at least 3 injured structures including nerves | 3 | 0.0 | 3.0 |
| Closed injury of bone, joint, and soft tissue | Conservative management or open reduction of fractures and ligament injuries | 12 | 0.0 | 12.1 |
| Soft tissue disorder | Treatment of ganglion cysts of tendons, tendovaginitis, synovialitis, and tumors | 46 | 54.5 | 28.3 |
| Joint disorder | Arthroplasty, ganglion cyst, arthroscopy, and arthrodesis | 39 | 39.4 | 26.3 |
| Bone disorder | Treatment of tumors and avascular necrosis | 9 | 3.0 | 8.1 |
| Elective posttraumatic surgery | Tenolysis, tendon reconstruction, and hand therapy (pulley insufficiency)c | 8 | 3.0 | 7.1 |
| Elective posttraumatic nerve surgery | Neurolysis, nerve reconstruction, and hand therapy (special stretching exercises)d | 3 | 3.0 | 2.0 |
| Compression neuropathy | Neurolysis, decompression, and hand therapy (special stretching exercises)d | 20 | 3.0 | 19.2 |
| Co-diagnosis infection | Conservative management and/or debridement of involved structures | 9 | 0.0 | 9.1 |
| Co-diagnosis CRPS I/II | Conservative treatment, and hand therapy | 20 | 21.2 | 13.1 |
| Others | Conservative or surgical treatment | 9 | 10.0 | 5.0 |
Notes:
a
Note that patients may fulfill diagnostic criteria for more than one disorder. Therefore, the total number of diagnoses (n) exceeds the sample size. Percentage values refer to the proportion of patients in each group with a particular diagnosis,
b
partial pulp amputations are treated conservatively by occluded wound dressings,
c
some patients with partial pulley insufficiency or tenodesis were treated conservatively by splints and hand therapy,
d
some patients with dysesthesias or painful hypesthesias were conservatively treated with special desensitivation programs by hand therapy.
Abbreviation: CRPS, complex regional pain syndrome.