Abstract

HAND AND WRIST ORTHOPEDIC SURGERY AT THE NAZARETH TOWERS DURING 2015-2016: EPIDEMIOLOGY AND RISK FACTORS

Youssef Awni and *Prof. Dr. Bowirrat Abdalla 

Abstract

Introduction: The hand and wrist considered a unique and sophisticated part of the human body that is composed of delicate structures encompasses bone, ligaments, tendons, muscles, nerves, skin, and blood vessels. In this study, we stress the importance of the outpatient clinic as a novelty development for performing small surgeries and it various benefits. Methods/participants: In a retrospective study, we assessed the surgical procurers of hands and wrists, their types; in addition to the risk factors underlying their pathology in the Nazareth medical towers in north Israel. 199 patients underwent hands and wrists surgery on an outpatient basis in the Nazareth medical towers, during 2015-2016. All participants underwent a series of interviews; demographic data and comprehensive clinical records at study entry after receiving a consent form agreements from all the participants. Electrodiagnostics testing used to confirm the diagnosis. Results: The total number of our patients who underwent surgical interventions for hands and wrists was = 199, the mean age was 54.7 ± 13.4 years. 110/199 (55.3%) underwent surgical intervention for Carpal Tunnel Syndrome (CTS); 70/199 (35%) underwent surgical intervention for Trigger Finger (TF); 9/199 (4.5%) performed (TF + CTS); 9/199 (4.5%) underwent surgical intervention for De Quervain’s Syndrome, so-called ―Techno Thumb,‖ and 1/199 (0.5%) underwent Ganglion surgery. Males were 40% and females 60%; Arabs patients were (n=94, 47%), Jews represent the majority (n=105, 53%). The education levels for our patients was as follow: 23/199 graduated from elementary school; 88/199 graduated from secondary school; 28/199 graduated from college; and 33/199 graduated from university. 46/199 (23%) suffered from Diabetes mellitus and 153/199 (77%) were diabetics free. Complications after surgery was reports in few patients as follow: 2/199 patients presented with secretion discharges and only 3/199 presented with redness and swelling. Conclusions: Recently a new development of outpatient surgery center at the Nazareath medical Towers, General Medical Services-Sheruti Briut Clalit- begin to give services to all patients who required small surgical procedures. A shifting phenomenon of small surgical procedures such hands and wrists has removed dramatically from inpatient to an outpatient setting. 88% of our patients were very satisfied with our services, 90% of patients were extremely satisfied of the reliability and good attitude of doctors and nurses. 92% recommend other people to consider our outpatient surgical center. Our study encourage the importance of this novelty in the light of the various advantages, which poured in the interest of the both parties: the outpatient center and the patients. Indeed, plethora of advantages observed because of this novelty. Reduced the recovery period and convenience of recovering in home, which generally makes recovery time quicker and easier than an in-hospital stay. Decreased stress is another advantage of outpatient in addition to the tremendous savings associated with outpatient surgeries when compared to the same procedure in a standard facility.

Keywords: Hand and wrist, Orthopedic surgery, Carpal Tunnel syndrome, Trigger Finger, De Quervain’s Syndrome, Outpatient Clinic.