Department of Orthopaedic Surgery, Seoul National University Hospital, Seoul, Korea.
Clin Orthop Relat Res. 2012 Aug;470(8):2202-8. doi: 10.1007/s11999-012-2253-3. Epub 2012 Jan 26.
Interpreting the impact of hand osteoarthritis (OA) on hand function is complicated owing to the multiple digits and joints in the hand.
QUESTIONS/PURPOSE: We determined the impact of digit-related radiographic OA on hand function in patients 65 years or older.
We evaluated hand radiographs in 196 men and 182 women older than 65 years without shoulder or elbow pain who participated in the Korean Longitudinal Study on Health and Aging. Using the Kellgren and Lawrence criteria, we graded the 15 joints in each hand from 0 to 4 for OA, and evaluated hand function by measuring DASH scores and grip and pinch strength of dominant hands. We performed multiple linear regression analyses to evaluate associations between hand functions and the sum of Kellgren and Lawrence grade of each digit.
The sums of Kellgren and Lawrence grades for thumbs and middle fingers were independently associated with grip strength, and the sums of the Kellgren and Lawrence grades for thumbs and index fingers were independently associated with pinch strength after controlling for age and sex. DASH scores were independently associated with OA of the thumb, or index or middle finger, but not with OA of the ring or small finger.
This study revealed cumulative effects of joint involvement and Kellgren and Lawrence grades of thumb and middle finger OA on grip strength, and thumb and index finger OA on pinch strength. Furthermore, OA of either of three radial digits was associated with more severe upper extremity disabilities.
Level IV, diagnostic study. See Guidelines for Authors for a complete description of levels of evidence.
由于手部有多个手指和关节，因此解释手部骨关节炎（OA）对手部功能的影响较为复杂。
问题/目的：我们确定了与手部相关的影像学 OA 对 65 岁及以上患者手部功能的影响。
我们评估了参加韩国健康老龄化纵向研究的 196 名男性和 182 名 65 岁以上无肩或肘痛的患者手部的 X 光片。使用 Kellgren 和 Lawrence 标准，我们对每只手的 15 个关节进行 0 到 4 级的 OA 分级，并通过测量 DASH 评分和优势手的握力和捏力来评估手部功能。我们进行了多元线性回归分析，以评估手部功能与每个手指的 Kellgren 和 Lawrence 分级总和之间的关系。
拇指和中指的 Kellgren 和 Lawrence 分级总和与握力独立相关，而拇指和食指的 Kellgren 和 Lawrence 分级总和与捏力独立相关，且均在控制年龄和性别后。DASH 评分与拇指、食指或中指的 OA 独立相关，但与环指或小指的 OA 不相关。
本研究揭示了关节受累和拇指及中指 OA 的 Kellgren 和 Lawrence 分级总和对握力的累积影响，以及拇指和食指 OA 对捏力的影响。此外，桡侧三个手指中的任何一个发生 OA 均与上肢功能障碍更严重相关。
IV 级，诊断研究。欲了解完整的证据水平描述，请参见作者指南。
