title: Trapeziometacarpal arthrosis: predictors of a second visit and surgery.
abstract: Trapeziometacarpal arthrosis is expected with advancing age and a limited percentage of people seek medical attention for it. We studied patients after their first appointment to address trapeziometacarpal arthrosis with a hand surgeon to determine factors associated with return for a second visit and eventual election of operative treatment. A billing database identified 306 patients in the practice of three hand surgeons with a new diagnosis of TMC arthrosis and no associated diagnoses. Bivariate and multivariable logistic regression analyses sought factors associated with a second visit and operative treatment among demographic and visit related factors. One hundred and forty-three patients (47 %) returned for one or more additional visits and 46 (15 %) eventually elected operative treatment within the study period. Independent predictors of a return visit included injection at first visit, splint at first visit, and doctor's recommendation for a return visit. The predictors of surgery were treating surgeon and prescription of a splint at the first visit, but splint at first visit was only predictive for one of the three surgeons. When patients first learn about their trapeziometacarpal arthrosis, the behavior of the hand surgeon may have a strong influence on return visits and eventual choice of operative treatment.
authors.affiliation: Hand and Upper Extremity Service, Massachusetts General Hospital, Harvard Medical School, Yawkey Center, Suite 2100, 55 Fruit Street, Boston, MA 02114 USA.
authors.forename: Alida Elisabeth Anna
authors.initials: AE
authors.lastname: Ochtman
authors.affiliation: Hand and Upper Extremity Service, Massachusetts General Hospital, Harvard Medical School, Yawkey Center, Suite 2100, 55 Fruit Street, Boston, MA 02114 USA.
authors.forename: Thierry G
authors.initials: TG
authors.lastname: Guitton
authors.affiliation: Hand and Upper Extremity Service, Massachusetts General Hospital, Harvard Medical School, Yawkey Center, Suite 2100, 55 Fruit Street, Boston, MA 02114 USA.
authors.forename: Geert A
authors.initials: GA
authors.lastname: Buijze
authors.affiliation: Hand and Upper Extremity Service, Massachusetts General Hospital, Harvard Medical School, Yawkey Center, Suite 2100, 55 Fruit Street, Boston, MA 02114 USA.
authors.forename: David
authors.initials: D
authors.lastname: Zurakowski
authors.affiliation: Hand and Upper Extremity Service, Massachusetts General Hospital, Harvard Medical School, Yawkey Center, Suite 2100, 55 Fruit Street, Boston, MA 02114 USA.
authors.forename: Chaitanya
authors.initials: C
authors.lastname: Mudgal
authors.affiliation: Hand and Upper Extremity Service, Massachusetts General Hospital, Harvard Medical School, Yawkey Center, Suite 2100, 55 Fruit Street, Boston, MA 02114 USA.
authors.forename: Jesse B
authors.initials: JB
authors.lastname: Jupiter
authors.affiliation: Hand and Upper Extremity Service, Massachusetts General Hospital, Harvard Medical School, Yawkey Center, Suite 2100, 55 Fruit Street, Boston, MA 02114 USA.
authors.forename: David
authors.initials: D
authors.lastname: Ring
keywords: Injection; Return visit; Splint; Surgery; Trapeziometacarpal arthrosis