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手部优势对腕部骨折术后功能评估的影响

The Influence of Hand Dominance in Wrist Fracture Post-Operative Functional Evaluation.

作者信息

Wollstein Ronit, Michael Dafna, Harel Hani, Carlson Lois

机构信息

New York University School of Medicine, New York, NY, USA.

Carmel Lady Davis Medical Center, Haifa, Israel.

出版信息

Plast Surg (Oakv). 2021 Nov;29(4):250-256. doi: 10.1177/2292550320933693. Epub 2020 Sep 2.

Abstract

Sensorimotor testing is used to measure outcomes in surgery, to document results of treatment and rehabilitation, and to compare results between surgeons, therapists, and institutions. When performing sensorimotor testing, failure to address dominant side differences may cause a bias in evaluation of outcomes. This study evaluated the effect of hand dominance on outcomes testing performed on patients following surgery for distal radius fractures (DRF). We hypothesized that the injured dominant hand will perform differently than the injured non-dominant hand. This is a retrospective study of patients following DRF treated surgically and evaluated in therapy. The patients were evaluated at fixed intervals: initially, at 6 weeks, and at 3 months post-surgery. Testing included grip strength, monofilaments, static and moving 2-point discrimination, Moberg testing, and stereognosis. Sixty patients included 46 (76.6%) females. Age averaged 62.1 (standard deviation: 16.9) years, and 54 were right-handed (90%). There were differences between dominant and non-dominant hand injury in 2 of 9 tests of sensibility for each time period, including little finger monofilament and Moberg testing initially, and moving 2-point discrimination in the little finger, monofilament testing of the thumb at 3 months. Both groups improved between initial and 3-month evaluation without differences in amount of improvement. Despite some significant differences in the applied tests between dominant and non-dominant injured hands, our results do not support correction for hand-dominance when using the described examinations in evaluating outcomes following DRF surgery.

摘要

感觉运动测试用于衡量手术效果、记录治疗与康复结果,并比较外科医生、治疗师及机构之间的结果。进行感觉运动测试时,若未考虑优势侧差异,可能会导致结果评估出现偏差。本研究评估了手的优势对桡骨远端骨折(DRF)手术后患者进行的结果测试的影响。我们假设受伤的优势手与受伤的非优势手表现不同。这是一项对接受手术治疗并在治疗中接受评估的DRF患者的回顾性研究。在固定时间点对患者进行评估:最初、术后6周和3个月。测试包括握力、单丝测试、静态和动态两点辨别、莫伯格测试和实体觉。60例患者中包括46例(76.6%)女性。平均年龄为62.1岁(标准差:16.9),54例为右利手(90%)。在每个时间段的9项感觉测试中,有2项测试中优势手损伤与非优势手损伤存在差异,包括最初的小指单丝测试和莫伯格测试,以及3个月时小指的动态两点辨别、拇指的单丝测试。两组在初始评估和3个月评估之间均有改善,改善程度无差异。尽管优势手损伤与非优势手损伤在应用测试中有一些显著差异,但我们的结果不支持在使用所述检查评估DRF手术后的结果时校正手的优势。

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