Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA, 02215, USA.
Clin Orthop Relat Res. 2010 Jul;468(7):1796-803. doi: 10.1007/s11999-009-1210-2.
Despite the prevalence of carpal and cubital tunnel syndrome, and relief of symptoms following timely surgical release, it is unclear how nonclinical patient characteristics affect disease management.
QUESTIONS/PURPOSES: We examined the effects of a variety of factors, such as age, gender, and socioeconomic status on the management of both carpal and cubital tunnel syndromes.
We retrospectively reviewed the records of all 273 patients seen by two hand surgeons with a diagnosis of either carpal or cubital tunnel syndrome between January 2005 and January 2007. Demographic, clinical (diagnosis, treatment), and socioeconomic (insurance type, median income) information was collected. Census data (2000) were used to collect information on median household income. The average age was 52 years (range, 19-87 years), and 65% of the patients were women (n = 178). Eighteen patients had Workers Compensation. Of the 273 patients, 86 (32%) had two or more diagnoses.
Among patients with carpal tunnel syndrome, there was a higher proportion of female patients compared to male patients (68% versus 32%); male patients with multiple neuropathies had higher rates of surgery than their female counterparts (63% versus 41%). Only increasing age was associated with increasing likelihood of surgery. Among multiple-diagnosis patients, those with Workers Compensation (n = 6) had higher wait times for surgery than their counterparts (n = 46) (126 days versus 26 days).
Patient age was the most important predictor of surgical release, and among those with multiple neuropathies, male patients were more likely to have surgery than female patients. Patients with Workers Compensation may experience long wait times to surgery.
Level II, prognostic study. See Guidelines for Authors for a complete description of levels of evidence.
尽管腕管和肘管综合征很常见，且及时手术松解后症状会得到缓解，但目前尚不清楚非临床患者特征如何影响疾病的管理。
问题/目的：我们研究了多种因素（如年龄、性别和社会经济地位）对腕管和肘管综合征管理的影响。
我们回顾性分析了 2005 年 1 月至 2007 年 1 月期间由两位手外科医生诊治的 273 例诊断为腕管或肘管综合征的患者的记录。收集了人口统计学、临床（诊断、治疗）和社会经济（保险类型、中位数收入）信息。使用人口普查数据（2000 年）收集中位数家庭收入信息。平均年龄为 52 岁（范围，19-87 岁），65%的患者为女性（n=178）。18 例患者有工人赔偿。在 273 例患者中，86 例（32%）有两种或两种以上的诊断。
在腕管综合征患者中，女性患者的比例高于男性患者（68%对 32%）；患有多种神经病变的男性患者手术率高于女性患者（63%对 41%）。只有年龄增长与手术可能性增加相关。在多诊断患者中，有工人赔偿（n=6）的患者手术等待时间长于无工人赔偿（n=46）的患者（126 天对 26 天）。
患者年龄是手术松解的最重要预测因素，在患有多种神经病变的患者中，男性患者比女性患者更有可能接受手术。有工人赔偿的患者可能需要等待很长时间才能进行手术。
II 级，预后研究。有关证据水平的完整描述，请参见作者指南。
