Prevalence of complications and association with patient-reported outcomes after trapeziectomy with a Weilby sling: A cohort study

Lisa Hoogendam*, Mark J.W. van der Oest, the Hand-Wrist Study Group, Guus M. Vermeulen, Reinier Feitz, Steven E.R. Hovius, J. Michiel Zuidam, Harm P. Slijper, Ruud W. Selles, Robbert M. Wouters

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

Purpose: The primary aim of this study was to report complications during the first year after trapeziectomy with Weilby sling using a standardized tool designed by the International Consortium for Health Outcome Measures. The secondary aim was to determine the association of complications and patient-reported outcomes 12 months after surgery. Methods: We included patients who underwent trapeziectomy with Weilby sling between November 2013 and December 2018. All complications during the first year were scored using the International Consortium for Health Outcomes Measurement Complications in Hand and Wrist conditions (ICHAW) tool. Pain and hand function were measured before surgery and 12 months after surgery using the Michigan Hand Outcomes Questionnaire (MHQ). Minimally Important Change thresholds of 18.6 for MHQ pain and 9.4 for MHQ function were used to determine clinical importance. Results: Of 531 patients after trapeziectomy with Weilby sling, 65% had an uneventful recovery, 16% experienced ICHAW Grade 1 deviations only, and 19% experienced Grade 2 or 3 deviations, including requiring antibiotics, corticosteroid injections, or additional surgery. On average, patients improved in pain and hand function, even in the presence of ICHAW events. Although all ICHAW grades were associated with poorer patient-reported outcomes 12 months after surgery, Grade 2 and 3 exceeded the Minimally Important Change threshold for pain and/or function. Conclusions: In 531 patients, 65% had an uneventful recovery, 16% experienced ICHAW Grade 1 deviations only, and 19% experienced grade 2 or 3 deviations. We recommend describing Grade 1 as “adverse protocol deviations” and grade 2 and 3 as complications, because of clinically relevant poorer patient-reported outcomes 12 months after surgery. The ICHAW is a promising tool to evaluate systematically and compare complications in hand surgery, although we recommend further evaluation. Type of study/level of evidence: Therapeutic IV.

Original languageEnglish
Pages (from-to)469-478
Number of pages10
JournalJournal of Hand Surgery
Volume48
Issue number5
Early online date15 Mar 2023
DOIs
Publication statusPublished - May 2023

Bibliographical note

Funding Information:
The authors thank all patients who participated and allowed their data to be used anonymously for the present study.

Publisher Copyright:
© 2023

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