Complications in Hand Surgery During Early Independent Practice: A Single Surgeon's 5-Year Experience.

IF 1.8 Q2 ORTHOPEDICS HAND Pub Date : 2025-03-01 Epub Date: 2023-10-03 DOI:10.1177/15589447231201875

Richard Samade, Adam M Gordon, Parth Vaghani, Kanu S Goyal

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Abstract

Background: The objective of this study was to understand the frequency and types of complications, and the associated postoperative outcomes within the first 5 years of practice after hand and upper extremity surgery fellowship.

Methods: This was a retrospective observational study of all patients seen and surgically treated by a single surgeon at a single institution from August 2014 to September 2019. This corresponded to the first 5 years of practice after fellowship. Data collected included patient demographics, perioperative data, complication type, and outcome of the complication (better/same/worse than preoperative status). Complications were classified using the Clavien-Dindo system and a unique, self-derived system.

Results: In total, 3301 surgeries were performed during the first 5 years of practice. The overall complication rate was 7.9% (261 complications from 239 patients). The 30-day complication rate was 5.2% (171/3301). Eleven (4.2%) of the 261 complications occurred intraoperatively. The total number of complications significantly declined during the first 5 years of practice as follows: 74, 71, 46, 37, and 33 (P = .010, R² = .92). Hand and wrist were the most frequent anatomic locations involved and bone pathology was the predominant indication.

Conclusion: The overall surgical complication rate for hand and upper extremity surgery was 7.9%, with a 30-day complication rate of 5.2% (171/3301). The rate of complications after fellowship declined over the first 5 years of independent practice. Superficial infections were the most common complication. More than 90% of patients ultimately improved after addressing the complication.

Level of evidence: IV.

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早期独立实践中的手外科并发症：一位外科医生5年的经验。

背景：本研究的目的是了解手部和上肢手术奖学金后前5年内并发症的频率和类型，以及相关的术后结果。方法：这是一项回顾性观察性研究，对2014年8月至2019年9月在一家机构由一名外科医生就诊和手术治疗的所有患者进行了研究。这相当于研究生毕业后的前5年实践。收集的数据包括患者人口统计学、围手术期数据、并发症类型和并发症的结果（比术前状态更好/相同/更差）。使用Clavien-Dindo系统和一个独特的、自衍生的系统对并发症进行分类。结果：在执业的前5年，共进行了3301次手术。总并发症发生率为7.9%（239例患者中有261例并发症）。30天并发症发生率为5.2%（171/3301）。261例并发症中有11例（4.2%）发生在术中。在前5年的实践中，并发症总数显著下降，如下：74、71、46、37和33（P=.010，R2=.92）。手和手腕是最常见的解剖部位，骨骼病理是主要指征。结论：手部和上肢手术的总并发症发生率为7.9%，30天并发症发生率5.2%（171/3301）。在最初5年的独立实践中，联谊后的并发症发生率有所下降。浅表感染是最常见的并发症。超过90%的患者在解决并发症后最终得到改善。证据级别：四。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

HAND Medicine-Surgery

CiteScore

3.30

自引率

0.00%

发文量

209

期刊介绍： HAND is the official journal of the American Association for Hand Surgery and is a peer-reviewed journal featuring articles written by clinicians worldwide presenting current research and clinical work in the field of hand surgery. It features articles related to all aspects of hand and upper extremity surgery and the post operative care and rehabilitation of the hand.