Long-term patient satisfaction after reconstructive upper extremity surgery to improve arm-hand function in tetraplegia.

ABSTRACT

STUDY DESIGN: There is a paucity of literature about satisfaction after reconstructive surgery to improve upper limb function in persons with tetraplegia. The present literature describes mainly functional outcomes. OBJECTIVES: To evaluate long-term satisfaction after reconstructive upper extremity surgery in persons with tetraplegia. SETTING: Two rehabilitation centers in the Netherlands. METHOD: A three-part questionnaire consisting questions regarding satisfaction, activities, occupation, changes in functional ability and willingness to undergo the surgeries again was used. Internal reliability of the questionnaire was verified by factor analysis and calculation of Cronbach's alpha. RESULTS: In total, 39 out of 55 persons (70.9%) participated in the study. The participants' responses to questions about satisfaction, activities and occupation were positive in 73.5, 67.6 and 35.0%, respectively. Nearly 81% improved their functional ability. Approximately 65% of the participants were willing to undergo elbow extension surgery again and 77.1% expressed their willingness to undergo hand/wrist surgery again. Significant positive correlation was found between willingness to have surgery again and improvement in activities and occupation Spearman's correlation coefficients activities-elbow extension 0.63 (P=0.003), activities-hand/wrist 0.57 (P<0.001), occupation-elbow extension 0.53 (P=0.025), occupation-hand/wrist 0.57 (P=0.001). Differences between the subgroups who would have surgery again and those who would refrain were also significant; one-way analysis of variance for activities (F=9.54, P<0.01) and for occupation (F=6.60, P<0.02). CONCLUSION: In the Netherlands, the majority of persons with tetraplegia who underwent reconstructive upper extremity surgery were satisfied with the results. This was related to improvement in activities and occupation.