Schuth Olga, Powers Jeremy, Merritt Wyndell, Blanchet Nadia
Division of Plastic and Reconstructive Surgery, Virginia Commonwealth University, Richmond, Va.
Private Practice, Richmond, Va.
Plast Reconstr Surg Glob Open. 2020 Apr 24;8(4):e2768. doi: 10.1097/GOX.0000000000002768. eCollection 2020 Apr.
As surveys reveal the prevalence of musculoskeletal pain among surgeons, it is important to have an appreciation and understanding of surgical ergonomics to protect against long-term injuries and mitigate the symptoms of existing conditions. Surgeons diagnosed with thumb carpometacarpal (CMC) joint osteoarthritis, a progressive and debilitating condition, can be especially vulnerable to the pain caused by the repetitive manual tasks of operating.
In this article, the authors describe a case of occupational thumb CMC arthritis in a right-hand dominant plastic surgeon and provide an ergonomic analysis of the different needle holders.
Following diagnosis, the simple switch from the traditional Hegar needle holder to the Mathieu needle driver with its palm grip and rotating ratchet lock mechanism stalled the progression of the disease, allowing the surgeon to continue operating pain free.
This is the first report of utilization of an alternative needle holder leading to the resolution of thumb pain. In sharing this case, the authors hope to bring awareness to the importance of hand ergonomics in the operating room and offer a practical tip to surgeons with CMC arthritis.
调查显示外科医生中肌肉骨骼疼痛的患病率较高，因此了解和认识手术人体工程学对于预防长期损伤和缓解现有病症的症状非常重要。被诊断患有拇指腕掌（CMC）关节骨关节炎（一种渐进性且使人衰弱的病症）的外科医生，尤其容易受到手术中重复性手工任务所引起疼痛的影响。
在本文中，作者描述了一名以右手为主的整形外科医生患职业性拇指CMC关节炎的病例，并对不同的持针器进行了人体工程学分析。
诊断后，从传统的黑加尔持针器简单切换到具有手掌握持和旋转棘轮锁定机制的马蒂厄持针钳，使疾病的进展得以停滞，让这位外科医生能够继续无痛手术。
这是关于使用替代持针器使拇指疼痛得到缓解的首份报告。在分享这个病例时，作者希望提高人们对手术室手部人体工程学重要性的认识，并为患有CMC关节炎的外科医生提供一个实用的小贴士。
