Bruyns Coen N P, Jaquet Jean-Bart, Schreuders Ton A R, Kalmijn Sandra, Kuypers Paul D L, Hovius Steven E R
Department of Plastic and Reconstructive Surgery, Erasmus Medical Center, Rotterdam, The Netherlands.
J Hand Surg Am. 2003 Jan;28(1):28-34. doi: 10.1053/jhsu.2003.50026.
One of the consequences of median and ulnar nerve trauma is delayed return to work. The aim of this study was to determine return to work (RTW) and risk factors for delayed RTW in addition to time off work (TOW). Differences among median, ulnar, and combined median-ulnar nerve injuries were examined.
In this study 96 patients who were employed at the time of injury and who had undergone surgery for median, ulnar, or combined nerve injuries between 1990 and 1998 were evaluated. The response rate was 84% (n = 81).
Within 1 year after injury, 59% (n = 48) returned to work. Mean TOW was 31.3 weeks. Return to work after combined nerve injuries was 24% versus after isolated median (80%) and ulnar (59%) nerve injuries. Level of education, type of job, and compliance to hand therapy were predictors for RTW. Furthermore, grip strength loss, tip pinch strength loss, and sensory recovery differed strongly between the RTW and no-RTW population.
The predictors found in this study increase our understanding of delayed RTW after median and ulnar nerve injury and may be used to optimize postinjury rehabilitation.
正中神经和尺神经损伤的后果之一是复工延迟。本研究的目的是确定复工情况以及除停工时间外延迟复工的风险因素。研究了正中神经、尺神经及正中 - 尺神经联合损伤之间的差异。
本研究对96例在受伤时已就业且于1990年至1998年间接受正中神经、尺神经或联合神经损伤手术的患者进行了评估。应答率为84%（n = 81）。
受伤后1年内，59%（n = 48）的患者复工。平均停工时间为31.3周。联合神经损伤后的复工率为24%，而单纯正中神经损伤（80%）和尺神经损伤（59%）后的复工率则较高。教育程度、工作类型和对手部治疗的依从性是复工的预测因素。此外，复工人群和未复工人群之间握力丧失、指尖捏力丧失和感觉恢复情况差异很大。
本研究中发现的预测因素增进了我们对正中神经和尺神经损伤后延迟复工的理解，并可用于优化伤后康复。
