TY - JOUR
T1 - Factors Associated with Patient Delay in Scaphoid Nonunions
AU - Heidsieck, David S. P.
AU - ten Berg, Paul W. L.
AU - Schep, Niels W. L.
AU - Strackee, Simon D.
PY - 2015
Y1 - 2015
N2 - Delay in seeking medical attention by patients, ─so-called patient delay, contributes to the relative high rate of delayed diagnosis and treatment in scaphoid nonunion cases. In this retrospective study we investigated the incidence of patients with a patient delay exceeding 6 months, thus by definition having an established nonunion. In addition to this, we investigated demographic, injury and patient related factors associated with this patient delay in scaphoid nonunion patients. We included 101 patients with established scaphoid nonunions treated surgically at our specialized hand surgery unit. Information regarding demographic and injury characteristics, and subjective patient related factors was obtained from medical records and a questionnaire-based survey. Sixty-four patients (63 %) responded to our survey. A quarter (25 %) of the patients showed a delay of more than 6 months. Demographic and injury characteristics were not related to this delay. In contrast to this, not attributing post-injury symptoms to a fracture but to e.g. a sprain instead, showed to be an independent predictor of patient delay. We report a high incidence of patients with an established scaphoid nonunion who delayed seeking medical attention. As there appears to be no demographic or injury characteristics associated with this patient delay, future developments of strategies to reduce patient delay should be targeted on all patients with a suspected scaphoid injury
AB - Delay in seeking medical attention by patients, ─so-called patient delay, contributes to the relative high rate of delayed diagnosis and treatment in scaphoid nonunion cases. In this retrospective study we investigated the incidence of patients with a patient delay exceeding 6 months, thus by definition having an established nonunion. In addition to this, we investigated demographic, injury and patient related factors associated with this patient delay in scaphoid nonunion patients. We included 101 patients with established scaphoid nonunions treated surgically at our specialized hand surgery unit. Information regarding demographic and injury characteristics, and subjective patient related factors was obtained from medical records and a questionnaire-based survey. Sixty-four patients (63 %) responded to our survey. A quarter (25 %) of the patients showed a delay of more than 6 months. Demographic and injury characteristics were not related to this delay. In contrast to this, not attributing post-injury symptoms to a fracture but to e.g. a sprain instead, showed to be an independent predictor of patient delay. We report a high incidence of patients with an established scaphoid nonunion who delayed seeking medical attention. As there appears to be no demographic or injury characteristics associated with this patient delay, future developments of strategies to reduce patient delay should be targeted on all patients with a suspected scaphoid injury
U2 - https://doi.org/10.1007/s12593-015-0206-2
DO - https://doi.org/10.1007/s12593-015-0206-2
M3 - Article
C2 - 26578833
SN - 0974-3227
VL - 7
SP - 300
EP - 305
JO - Journal of hand and microsurgery
JF - Journal of hand and microsurgery
IS - 2
ER -