Factors Associated with Patient Delay in Scaphoid Nonunions

David S.P. Heidsieck; Paul W.L. ten Berg; Niels W.L. Schep; Simon D. Strackee

doi:10.1007/s12593-015-0206-2

Journal of Hand and Microsurgery, Table of Contents

J Hand Microsurg 2015; 07(02): 300-305
DOI: 10.1007/s12593-015-0206-2

Original Article

Thieme Medical and Scientific Publishers Private Ltd.

Factors Associated with Patient Delay in Scaphoid Nonunions

Authors

David S.P. Heidsieck

¹Department of Plastic-, Reconstructive- and Hand surgery, Academic Medical Center, University of Amsterdam, Suite G4-226, PO box 22660, 1100 DD, Amsterdam, The Netherlands Email: d.s.heidsieck@amc.uva.nl
Paul W.L. ten Berg

¹Department of Plastic-, Reconstructive- and Hand surgery, Academic Medical Center, University of Amsterdam, Suite G4-226, PO box 22660, 1100 DD, Amsterdam, The Netherlands Email: d.s.heidsieck@amc.uva.nl
Niels W.L. Schep

²Department of Trauma Surgery, Maasstad Hospital, Rotterdam, The Netherlands
Simon D. Strackee

¹Department of Plastic-, Reconstructive- and Hand surgery, Academic Medical Center, University of Amsterdam, Suite G4-226, PO box 22660, 1100 DD, Amsterdam, The Netherlands Email: d.s.heidsieck@amc.uva.nl

Subject Editor:

Abstract

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Abstract

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.

Keywords

Scaphoid - Nonunion - Delay - Medical attention

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References

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