Hand Therapy after Flexor and Extensor Tendon Repair: Assessing Predictors of Loss to Follow-up

Abstract

Background: Postoperative hand therapy (HT) is important for regaining function and preventing complications in patients undergoing tendon repair of the hand and wrist. Loss to follow-up (LTFU) can hinder this process; so we sought to determine factors that predict attrition of these patients. Methods: Charts were retrospectively reviewed for patients who underwent extensor or flexor tendon repair of the hand, wrist, or forearm between 2014 and 2019. Demographic data, including age, sex, zip code, employment status, education level, and insurance type, were collected, and the rate of LTFU was calculated. Logistic regression was used to analyze factors. Results: A total of 149 patients were identified and analyzed. The rate of LTFU was 42%. Factors that predicted loss were younger age, male gender, lower educational degree, and a documented psychiatric history. Employment status, insurance type, and distance from the HT center did not predict attrition. The number of HT weeks recommended by the occupational therapist did not differ between those who were lost and those who were not. Lost patients completed, on average, 57% of their suggested HT course. Conclusions: The current study identified demographic factors associated with attrition in patients undergoing tendon repair of the distal upper extremity. Factors included patients who were younger, male gender, less educated, and had a documented psychiatric history. By identifying factors that predict LTFU, specific strategies can be developed to reduce attrition rates, particularly for at-risk populations, to improve patient care after tendon repair.