Outcomes of XXXX surgery with and without supervised postoperative therapy.

@entity1 @entity923 @entity282 @entity158
PURPOSE: To assess if a formal 2-week hand therapy improves outcomes and justifies its expense. METHODS: A prospective randomized study was completed using a contemporary short incision and a 2-week program of therapy. @entity1 were randomized into 2 treatment groups: one group received instruction on home therapy exercises to be followed after @entity923 release, and a second group received the home program in addition to a therapist-directed program for 2 weeks. Variables measured were @entity1 age, gender, preoperative and @entity282 scores, grip and pinch strengths, return to modified and regular work, insurance coverage, and job category. Both groups were followed for 6 months postoperatively. RESULTS: One hundred fifty @entity1 (110 @entity1 and 40 @entity1 ) entered and completed the study. The average age was 46 years (range, 29-70 years). The average age, gender distribution, insurance coverage, and breakdown of job categories between groups was not statistically significant. There was no difference in return to work times between those with and without postoperative therapy; however, @entity1 covered by workers' compensation insurance were slower to return to both modified and regular work compared with the other groups. The postoperative grip and pinch strengths, @entity158 and Disabilities of the Arm, Shoulder, and Hand scores did not show statistical differences between groups at any of the measured time periods. Depending on insurance carrier, directed therapy added  600 to  900 to the cost of care. CONCLUSIONS: The current randomized study failed to show benefit in a 2-week course of hand therapy after @entity923 release using a short incision. The cost of supervised therapy for an uncomplicated @entity923 release seems unjustified.
