Lutsky Kevin, Kim Nayoung, Medina Juana, Maltenfort Mitchell, Beredjiklian Pedro K
Orthopedics. 2016 May 1;39(3):e444-8. doi: 10.3928/01477447-20160315-02. Epub 2016 Mar 29.
The goals of this study were to (1) assess how frequently patients present for evaluation of common hand disorders in relation to hand dominance and (2) evaluate the effect of hand dominance on function in patients with these conditions. The authors hypothesized that (1) the majority of patients who seek evaluation would have a condition that affects the dominant hand, and (2) disability scores would be worse if the dominant hand is involved. They retrospectively reviewed the records of consecutive patients who presented for treatment to their institution with unilateral symptoms of 5 common disorders of the hand: carpal tunnel syndrome (CTS), de Quervain's tenosynovitis (DEQ), lateral epicondylitis (LE), hand osteoarthritis (OA), and trigger finger (TF). The authors assessed the effect of diagnosis and hand dominance on Disabilities of the Arm, Shoulder and Hand (DASH) scores. The study group comprised 1029 patients (379 men and 650 women) with a mean age of 59.5 years. Ninety percent were right-hand dominant. The dominant and nondominant hands were affected with relatively equal frequency for CTS, DEQ, OA, and TF (range, 45%-53%). Patients with LE had a significantly higher incidence of dominant hand involvement. Men had lower DASH scores than women by an average of 7.9 points, and DASH scores were significantly but slightly higher for the overall group (3.2 points) when the dominant side was affected. Men with LE and women with TF and OA had significantly higher DASH scores when their dominant extremity was affected. Common hand disorders such as CTS, DEQ, OA, and TF affect the dominant and nondominant hands in roughly equivalent proportions, whereas LE is more common on the dominant side. Dominant hand involvement results in significantly worse DASH scores, although the magnitude of this is relatively small. Women have significantly higher DASH scores than men for the conditions evaluated. [Orthopedics. 2016; 39(3):e444-e448.].
(1)评估患者因常见手部疾病前来评估的频率与利手的关系;(2)评估利手对患有这些疾病的患者功能的影响。作者假设:(1)寻求评估的大多数患者所患疾病会影响优势手;(2)如果优势手受累,残疾评分会更差。他们回顾性分析了连续前来其机构治疗的单侧手部5种常见疾病(腕管综合征(CTS)、桡骨茎突狭窄性腱鞘炎(DEQ)、外侧肱骨髁炎(LE)、手部骨关节炎(OA)和扳机指(TF))患者的记录。作者评估了诊断和利手对上肢、肩部和手部功能障碍(DASH)评分的影响。研究组包括1029例患者(379例男性和650例女性),平均年龄59.5岁。90%为右利手。对于CTS、DEQ、OA和TF,优势手和非优势手受累的频率相对相等(范围为45%-53%)。LE患者优势手受累的发生率显著更高。男性的DASH评分比女性平均低7.9分,当优势侧受累时,整个组的DASH评分显著但略有升高(3.2分)。优势上肢受累时,患有LE的男性以及患有TF和OA的女性的DASH评分显著更高。CTS、DEQ、OA和TF等常见手部疾病对优势手和非优势手的影响比例大致相同,而LE在优势侧更为常见。优势手受累会导致DASH评分显著更差,尽管其幅度相对较小。在所评估的疾病中,女性的DASH评分显著高于男性。[《骨科学》。2016年;39(3):e444-e448。]