Unplanned Reoperation After Surgery for Scapholunate InterosseousLigament Insufficiency: A Retrospective Review of 316 Patients

摘要

Background: The purpose of this study was to identify factorsassociated with unplanned reoperation after surgery for scapholunateinterosseous ligament (SLIL) insufficiency. Methods: UsingCurrent Procedural Terminology (CPT) codes from 3 handsurgery centers across 2 metropolitan areas, we identified 316 patientsundergoing surgery for SLIL insufficiency from 2000 to 2014. Medical recordswere manually reviewed to collect data on factors that might be associated withunplanned reoperation, including age, sex, tobacco use, occupation, acuity oftreatment, and reconstruction method. Results: Thirty-eightpatients (12%) had an unplanned reoperation; most of them (65%) were a secondaryreconstruction or salvage procedure (eg, 6 proximal row carpectomies, 9 revisionreconstruction, and 10 partial carpal arthrodeses), while 5 (13%) were forunplanned screw removal. The median time between the index and second surgerywas 16 months (range, 2-97 months). The type of index procedure was notassociated with reoperation. The only factor associated with reoperation wascigarette smoking, and this association persisted when looking specifically atreoperations for revision or salvage. Conclusions: Patients shouldbe counseled that smoking is associated with reoperation after SLIL surgery.Smoking cessation or decreasing nicotine usage may be beneficial prior tosurgery. With the numbers available, there was no association between surgicaltechnique and reoperation.