title: The epidemiology of reoperation after flexor pulley reconstruction.
abstract: OBJECTIVE
  We used a statewide database to determine the incidence of pulley reconstruction and to evaluate the influence of demographics on reoperation. We hypothesized that age, insurance status, and concomitant nerve or tendon procedure would influence the likelihood of reoperation.
  
  
  METHODS
  We used the Statewide Planning and Research Cooperative System ambulatory surgery database from New York, which represents all outpatient surgery in the state. Patients who had flexor pulley reconstruction from 1998 to 2009 were identified using Current Procedural Terminology 4 codes. Subsequent surgery records for these patients were identified through 2010, allowing at least 1 year follow-up. Concomitant nerve procedure and flexor tendon repair/reconstruction were identified. The type and timing of subsequent procedures, including tenolysis and repeat pulley reconstruction, were recorded. Univariate statistics were calculated to compare age, sex, and payer type between patients with and without reoperation. A multivariable, logistic regression model was used to evaluate the association of the demographics with the chances of having reoperation.
  
  
  RESULTS
  There were 623 patients who had flexor pulley reconstruction from 1998 to 2009. The incidence of pulley reconstruction was 0.27 per 100,000 persons, with an annual frequency of 52 procedures. There were 39 (6%) reoperations. There was no difference in age, concomitant nerve or tendon repair, or workers' compensation between patients with and without reoperation. Regression modeling showed a higher likelihood among men of having reoperation.
  
  
  CONCLUSIONS
  Flexor pulley reconstructions are rare. One-quarter of surgeons performed only one flexor pulley reconstruction over a 12-year period. The 6% reoperation rate is similar to our previous findings for flexor tendon repair using similar methodology. Our report provides information that may be useful in counseling patients.
authors.affiliation: Hospital for Special Surgery, New York, NY 10021, USA.
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Dy
authors.forename: Stephen
authors.initials: S
authors.lastname: Lyman
authors.forename: Joseph J
authors.initials: JJ
authors.lastname: Schreiber
authors.forename: Huong T
authors.initials: HT
authors.lastname: Do
authors.forename: Aaron
authors.initials: A
authors.lastname: Daluiski
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D005260:Female; D005383:Finger Injuries / Q000601:surgery*; D006801:Humans; D019458:Insurance Coverage; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures; D012086:Reoperation / Q000706:statistics & numerical data; D013708:Tendon Injuries / Q000601:surgery*; D055815:Young Adult
keywords: epidemiology; flexor pulley; outcomes; socioeconomic