{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T02:36:10Z","timestamp":1793068570925,"version":"4.5.0"},"reference-count":23,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2023,10,3]],"date-time":"2023-10-03T00:00:00Z","timestamp":1696291200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Hand (New York, N,Y.)"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>The objective of this study was to understand the frequency and types of complications, and the associated postoperative outcomes within the first 5 years of practice after hand and upper extremity surgery fellowship.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This was a retrospective observational study of all patients seen and surgically treated by a single surgeon at a single institution from August 2014 to September 2019. This corresponded to the first 5 years of practice after fellowship. Data collected included patient demographics, perioperative data, complication type, and outcome of the complication (better\/same\/worse than preoperative status). Complications were classified using the Clavien-Dindo system and a unique, self-derived system.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      In total, 3301 surgeries were performed during the first 5 years of practice. The overall complication rate was 7.9% (261 complications from 239 patients). The 30-day complication rate was 5.2% (171\/3301). Eleven (4.2%) of the 261 complications occurred intraoperatively. The total number of complications significantly declined during the first 5 years of practice as follows: 74, 71, 46, 37, and 33 (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .010,\n                      <jats:italic toggle=\"yes\">R<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      = .92). Hand and wrist were the most frequent anatomic locations involved and bone pathology was the predominant indication.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>The overall surgical complication rate for hand and upper extremity surgery was 7.9%, with a 30-day complication rate of 5.2% (171\/3301). The rate of complications after fellowship declined over the first 5 years of independent practice. Superficial infections were the most common complication. More than 90% of patients ultimately improved after addressing the complication.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>IV<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15589447231201875","type":"journal-article","created":{"date-parts":[[2023,10,3]],"date-time":"2023-10-03T08:26:36Z","timestamp":1696321596000},"page":"296-304","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Complications in Hand Surgery During Early Independent Practice: A Single Surgeon\u2019s 5-Year Experience"],"prefix":"10.1177","volume":"20","author":[{"given":"Richard","family":"Samade","sequence":"first","affiliation":[{"name":"UT Southwestern Medical Center, Richardson, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam M.","family":"Gordon","sequence":"additional","affiliation":[{"name":"Medical College of Wisconsin, Milwaukee, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Parth","family":"Vaghani","sequence":"additional","affiliation":[{"name":"The Ohio State University, Columbus, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5507-0351","authenticated-orcid":false,"given":"Kanu S.","family":"Goyal","sequence":"additional","affiliation":[{"name":"The Ohio State University, Columbus, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2023,10,3]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhsa.2015.06.103"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2019.12.028"},{"key":"e_1_3_2_4_2","article-title":"Unplanned readmission in outpatient hand surgery: an analysis of 23,613 patients in the NSQIP data set","volume":"17","author":"Donato DP","year":"2017","unstructured":"Donato DP, Kwok AC, Bishop MO, et al. Unplanned readmission in outpatient hand surgery: an analysis of 23,613 patients in the NSQIP data set. Eplasty. 2017;17:e36. eCollection 2017.","journal-title":"Eplasty"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhsa.2016.10.007"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.15.01423"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhsa.2018.04.032"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhsa.2016.08.020"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1177\/1558944717744341"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2016.04.012"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhsg.2020.01.004"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhsa.2018.05.001"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhsa.2016.09.014"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0123593"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhsa.2017.10.015"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhsa.2005.10.010"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhsa.2014.04.018"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0363-5023(78)80118-X"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.sla.0000133083.54934.ae"},{"issue":"5","key":"e_1_3_2_20_2","article-title":"Decreasing unexpected returns to orthopedic hand clinic: improving efficiency of health care delivery","volume":"3","author":"Little KJ","year":"2018","unstructured":"Little KJ, Trehan S, Cornwall R, et al. Decreasing unexpected returns to orthopedic hand clinic: improving efficiency of health care delivery. Pediatr Qual Saf. 2018;3(5):e107.","journal-title":"Pediatr Qual Saf"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.mporth.2019.10.009"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e3181ef90cb"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-012-2343-2"},{"key":"e_1_3_2_24_2","article-title":"Reliability of the modified Clavien-Dindo-Sink complication classification system in pediatric orthopaedic surgery","volume":"203","author":"Dodwell ER","year":"2018","unstructured":"Dodwell ER, Pathy R, Widmann RF, et al. Reliability of the modified Clavien-Dindo-Sink complication classification system in pediatric orthopaedic surgery. JBJS Open Access. 2018;203:e0020.","journal-title":"JBJS Open Access"}],"container-title":["HAND"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15589447231201875","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/15589447231201875","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15589447231201875","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T10:03:31Z","timestamp":1792663411000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/15589447231201875"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,10,3]]},"references-count":23,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2025,3]]}},"alternative-id":["10.1177\/15589447231201875"],"URL":"https:\/\/doi.org\/10.1177\/15589447231201875","relation":{},"ISSN":["1558-9447","1558-9455"],"issn-type":[{"value":"1558-9447","type":"print"},{"value":"1558-9455","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,10,3]]}}}