Postoperative follow-up time and justification in prospective hand surgery research: a systematic review

Abstract

We systematically reviewed prospective studies for five hand procedures to analyse postoperative follow-up time, clinical or radiographic plateau, and whether the authors provide justification for times used. Demographic data, outcomes and mean follow-up were analysed. A total of 188 articles met our inclusion criteria. The mean postoperative follow-up time among these studies were carpal tunnel release, 21 months (range 1.5–111); cubital tunnel release, 27 months (2.5–46); open reduction and internal fixation for the distal radius fracture, 24 months (3–120); thumb carpometacarpal joint arthroplasty, 64 months (8.5–228); and flexor tendon repair, 25 months (3–59). Authors provided justification for follow-up intervals in 10% of these reports. We conclude that most prospective clinical studies in hand surgery do not properly justify follow-up length. Clinically unnecessary follow-up is costly without much benefit. In prospective research, we believe justified postoperative follow-up is essential, based on expected time to detect clinical plateau, capture complications and determine the need for secondary surgery. Level of evidence: III