title: Effectiveness of rheumatoid hand surgery: contrasting perceptions of hand surgeons and rheumatologists.
abstract: OBJECTIVE
  Surgical management of rheumatoid hand diseases is controversial with large variation in practice pattern in the U.S. The purpose of this study is to evaluate the attitudes of hand surgeons and rheumatologists toward the effectiveness of rheumatoid hand surgery.
  
  
  METHODS
  We designed a survey instrument to examine physicians' opinions about the effectiveness of different surgical treatments for rheumatoid hand deformities. The self-administered survey was mailed to a national random sample of 500 members of the American Society for Surgery of the Hand and 500 members of the American College of Rheumatology.
  
  
  RESULTS
  Of survey responders, 82.5% of hand surgeons versus 34.1% of rheumatologists believe metacarpophalangeal joint arthroplasty improves hand function; 93.2% and 54.6%, respectively, believe prophylactic extensor tenosynovectomy prevents tendon rupture; and 52.5% and 12.6%, respectively, believe small joint synovectomy delays joint destruction.
  
  
  CONCLUSIONS
  Rheumatologists view rheumatoid hand surgery as significantly less effective than do hand surgeons, which highlights the disagreements between the 2 specialties about the management of this clinical problem.
authors.affiliation: Robert Wood Johnson Clinical Scholars Program, Ann Arbor, MI, USA.
authors.forename: Amy K
authors.initials: AK
authors.lastname: Alderman
authors.forename: Kevin C
authors.initials: KC
authors.lastname: Chung
authors.forename: H Myra
authors.initials: HM
authors.lastname: Kim
authors.forename: David A
authors.initials: DA
authors.lastname: Fox
authors.forename: Peter A
authors.initials: PA
authors.lastname: Ubel
mesh_terms: D001172:Arthritis, Rheumatoid / Q000601:surgery*; D001178:Arthroplasty; D001291:Attitude of Health Personnel; D013502:General Surgery; D006225:Hand / Q000601:surgery*; D019538:Health Care Surveys; D006801:Humans; D008662:Metacarpophalangeal Joint / Q000601:surgery; D012219:Rheumatology; D016896:Treatment Outcome