title: The impact of a hand therapy screening and management clinic for patients referred for surgical opinion in an Australian public hospital.
abstract: METHODS
  Retrospective cohort study.
  
  
  OBJECTIVE
  To measure the impact of initial treatment by a hand therapist of people referred to a hand surgeon for common hand conditions.
  
  
  METHODS
  This retrospective cohort study included 224 patients with Carpal Tunnel Syndrome, Trigger Finger/Thumb, de Quervain's tenosynovitis, and trapeziometacarpal osteoarthrosis. All were invited to attend for assessment and non-operative treatment and were followed up for at least one year. Between groups comparisons for who attended (N = 164) and those who did not (N = 60) were conducted.
  
  
  RESULTS
  40.8% of the non-operative treatment group and 65% of the no treatment group underwent surgery, which was statistically significant (p = 0.02). Univariate analysis found that the variable "attending non-operative treatment" was able to predict those who did not have surgery (p = 0.02). Multivariate analysis using logistic regression also showed that this was the only significant predictor of not progressing to surgery (p = 0.001).
  
  
  CONCLUSIONS
  Assessment and treatment by a non-operative provider were associated with a decrease in the rate of operative treatment. Prospective, randomized studies could help determine if this observed difference is related to the treatment approach.
authors.affiliation: Monash University, Melbourne, Victoria, Australia; The Alfred, Melbourne, Victoria, Australia. Electronic address: lisa.obrien@monash.edu.
authors.forename: Lisa
authors.initials: L
authors.lastname: O'Brien
authors.forename: Alison
authors.initials: A
authors.lastname: Hardman
authors.forename: Sharon
authors.initials: S
authors.lastname: Goldby
mesh_terms: D002349:Carpal Tunnel Syndrome / Q000601:surgery / Q000628:therapy*; D053684:De Quervain Disease / Q000601:surgery / Q000628:therapy*; D005260:Female; D006225:Hand; D006779:Hospitals, Public; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D019637:Orthopedic Procedures / Q000706:statistics & numerical data; D010003:Osteoarthritis / Q000601:surgery / Q000628:therapy*; D012189:Retrospective Studies; D052582:Trigger Finger Disorder / Q000601:surgery / Q000628:therapy*; D014739:Victoria; D014850:Waiting Lists
keywords: Carpal tunnel syndrome; Extended scope practitioner; Trapeziometacarpal osteoarthrosis; Trigger finger; Trigger thumb; de Quervain's tenosynovitis