Woo Eugenia Hoi Chi, White Peter, Lai Christopher Wai Keung
Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong Special Administrative Region, China.
Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong Special Administrative Region, China.
J Hand Surg Am. 2019 Jul;44(7):610.e1-610.e15. doi: 10.1016/j.jhsa.2018.08.006. Epub 2018 Oct 6.
To investigate the effects of static hand postures during various finger and wrist positions on morphological changes of the median nerve within the carpal tunnel in intensive and nonintensive electronic device users.
Forty-eight university students, equally divided into intensive and nonintensive users (≥5 h/d and <5 h/d of electronic device usage, respectively), were randomly selected after questionnaire responses and evaluated clinically and by ultrasonography.
Intensive users reported more wrist/hand pain with a high severity score than nonintensive users. They also had larger median nerve cross-sectional areas, flattening ratios, and perimeters than nonintensive users, and showed less median nerve deformation under various finger and wrist positions. Compared with the neutral wrist position with all fingers extended for both intensive and nonintensive users, the cross-sectional areas decreased under finger flexion and grip, as well as wrist extension-flexion and radial-ulnar deviation. Overall, the average median nerve size of the dominant hand was much larger than that of the nondominant hand, especially for intensive users.
Wrist deviation from neutral can lead to more pronounced deformation of the median nerve than finger flexion for both intensive and nonintensive users. To minimize compression on the median nerve, it is important to keep the wrist as near to the neutral position as possible during computer-related work and avoid keeping the thumb and fingers in a static flexed position when using mobile devices, especially for single-hand use.
On the basis of this observational study, intensive users had enlarged and flattened median nerves as well as decreased nerve deformation during hand motions compared with nonintensive users. As overuse of electronic devices may adversely affect the median nerve, caution may be warranted.
研究频繁和非频繁使用电子设备人群在不同手指和手腕姿势下静态手部姿势对腕管内正中神经形态变化的影响。
通过问卷调查选取48名大学生，将其平均分为频繁使用者和非频繁使用者（分别为每天使用电子设备≥5小时和<5小时），并进行临床评估和超声检查。
频繁使用者报告的手腕/手部疼痛比非频繁使用者更严重，疼痛严重程度评分更高。他们的正中神经横截面积、扁平率和周长也比非频繁使用者更大，并且在不同手指和手腕姿势下正中神经的变形较小。与频繁和非频繁使用者所有手指伸展时的中立手腕姿势相比，手指屈曲和抓握以及手腕屈伸和桡尺偏斜时横截面积减小。总体而言，优势手的正中神经平均尺寸比非优势手大得多，尤其是频繁使用者。
对于频繁和非频繁使用者，手腕偏离中立位比手指屈曲会导致正中神经更明显的变形。为了尽量减少对正中神经的压迫，在进行与计算机相关的工作时，尽可能使手腕保持接近中立位非常重要，并且在使用移动设备时，尤其是单手使用时，避免拇指和手指保持静态屈曲姿势。
基于这项观察性研究，与非频繁使用者相比，频繁使用者的正中神经增大、变扁平，并且在手部运动时神经变形减少。由于过度使用电子设备可能会对正中神经产生不利影响，因此可能需要谨慎对待。
