The Role of Hand Surgery on Quality of Life and Patient Satisfaction in Rheumatologic Patients

Abstract

Objectives: Rheumatologic diseases, particularly rheumatoid arthritis (RA), often lead to hand and wrist dysfunction, significantly impairing patients’ quality of life. Despite advancements in pharmacotherapy, deformities, pain, and functional losses persist, necessitating surgical interventions. This study evaluates the outcomes of hand surgeries in rheumatologic diseases, focusing on functional improvements, pain relief, and patient satisfaction. Materials and Methods: A retrospective analysis was conducted on 17 patients with confirmed rheumatologic diagnoses, including RA, systemic lupus erythematosus, scleroderma, and ankylosing spondylitis, who underwent hand surgeries between 2021 and 2024. Functional outcomes were assessed using the sequential occupational dexterity assessment (SODA) and Duruoz Scale, along with grip strength and pain levels measured using a visual analog scale (VAS). Complications, postoperative erythrocyte sedimentation rate (ESR), and patient satisfaction were also evaluated. Results: Soft tissue surgeries (79.2%) were more prevalent than bone surgeries (20.8%). Significant improvements were observed in functional outcomes (SODA and Duruoz Scores), grip strength, and VAS scores for general and hand-specific pain. However, ESR values remained unchanged, indicating persistent systemic inflammation. Complications occurred in 23.5% of patients, including infections, tendon adhesions, and recurrence of deformities. Patient satisfaction scores were moderate, highlighting unmet expectations. Conclusion: Hand surgeries provide substantial functional and pain-related benefits for patients with rheumatologic diseases, but moderate satisfaction levels and high complication rates underscore the need for better preoperative counseling, implant accessibility, and multidisciplinary management. Future studies with larger cohorts are warranted to refine surgical approaches and improve outcomes.

Keywords

• Rheumatologic diseases
• hand surgery
• rheumatoid arthritis
• patient satisfaction
• functional outcomes

Romatolojik Hastalarda El Cerrahisinin Yaşam Kalitesi ve Hasta Memnuniyeti Üzerindeki Rolü

Abstract

Amaç: Romatolojik hastalıklar, özellikle romatoid artrit (RA), el ve bilek fonksiyon bozukluğuna yol açarak hastaların yaşam kalitesini olumsuz etkilemektedir. Farmakoterapideki ilerlemelere rağmen, deformiteler, ağrı ve fonksiyonel kayıplar devam etmekte olup, cerrahi müdahaleleri gerekli kılmaktadır. Bu çalışma, romatolojik hastalıklarda el cerrahisi işlemlerinin fonksiyonel iyileşme, ağrı hafifletme ve hasta memnuniyeti üzerindeki etkilerini değerlendirmektedir. Gereç ve Yöntem: 2021-2024 yılları arasında RA, sistemik lupus eritematozus, skleroderma ve ankilozan spondilit tanılarına sahip ve el cerrahisi geçiren 17 hasta üzerinde retrospektif bir analiz yapılmıştır. Fonksiyonel sonuçlar, sıralı işlevsel el yeterliliği değerlendirmesi (SODA) ve Duruöz Ölçeği ile değerlendirilmiş; kavrama gücü ve ağrı seviyeleri görsel analog skala (VAS) ile ölçülmüştür. Komplikasyonlar, ameliyat sonrası eritrosit sedimentasyon hızı (ESR) ve hasta memnuniyeti de değerlendirilmiştir. Bulgular: Yumuşak doku cerrahisi işlemleri (%79,2), kemik cerrahisi işlemlerinden (%20,8) daha yaygındı. Fonksiyonel sonuçlar (SODA ve Duruöz skorları), kavrama gücü ve genel ile el bölgesine özgü ağrı VAS skorlarında anlamlı iyileşmeler gözlenmiştir. Ancak, ESR değerlerinde değişiklik olmamış ve bu durum sistemik enflamasyonun devam ettiğini göstermiştir. Hastaların %23,5’inde enfeksiyon, tendon yapışmaları ve deformite nüksü gibi komplikasyonlar görülmüştür. Hasta memnuniyeti puanları ise orta düzeyde olup, karşılanmamış beklentilere işaret etmektedir. Sonuç: El cerrahisi işlemleri, romatolojik hastalarda fonksiyonel ve ağrıya bağlı önemli faydalar sağlamaktadır; ancak orta düzeyde memnuniyet oranları ve yüksek komplikasyon oranları, daha iyi ameliyat öncesi danışmanlık, implant erişilebilirliği ve multidisipliner yönetim ihtiyacını vurgulamaktadır. Daha geniş hasta gruplarıyla yapılacak gelecekteki çalışmalar, cerrahi yaklaşımların iyileştirilmesine ve sonuçların geliştirilmesine katkı sağlayacaktır.

Keywords

• Romatolojik hastalıklar
• el cerrahisi
• romatoid artrit
• hasta memnuniyeti
• fonksiyonel sonuçlar

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