Latif Joseph W, Aveledo Ricardo, Lam Patrick H, Murrell George A C
Orthopaedic Research Institute, St George Hospital Campus, University of New South Wales, Kogarah, NSW, Australia.
JSES Int. 2022 May 14;6(4):615-622. doi: 10.1016/j.jseint.2022.04.010. eCollection 2022 Jul.
Shoulder pain and loss of function are classically associated with rotator cuff tears, while paresthesia of the hand is not. We noted anecdotally that paresthesia of the arm was common in patients presenting with rotator cuff tears. The purpose of this study was to determine the prevalence and magnitude of hand paresthesia, its relationship to pain, and how surgery affected these symptoms.
This prospective cross-sectional study assessed the prevalence and magnitude of shoulder pain and hand numbness and tingling (as assessed by 2 questions from the modified Boston Carpal Tunnel Questionnaire) preoperatively and at 1 week, 6 weeks, 12 weeks, and 6 months postoperatively among 213 consecutive patients who presented for and underwent arthroscopic rotator cuff repair.
The preoperative levels of prevalence and severity of shoulder pain during rest, overhead activities, and sleep improved by 52%, 22%, and 34%, respectively, compared with those by 6 months postoperatively ( < .05). Seventy-five patients (33%) reported hand paresthesia before surgery. There was a 50% and 60% reduction in the severity of hand tingling and numbness, respectively, by 1 week after surgery ( < .05). The preoperative level of hand numbness (Wald statistic; W = 20) and whether the patient's shoulder problem was caused by a specific injury (W = 6) were predictive of the presence of hand numbness at 6 months after surgery ( < .05).
This study showed that many patients who undergo rotator cuff repairs present with hand paresthesia that is associated with their shoulder pain. The prevalence and severity of shoulder pain and hand numbness and tingling improved postoperatively.
肩痛和功能丧失通常与肩袖撕裂有关，而手部感觉异常则不然。我们注意到，在出现肩袖撕裂的患者中，手臂感觉异常很常见。本研究的目的是确定手部感觉异常的患病率和严重程度、其与疼痛的关系，以及手术如何影响这些症状。
这项前瞻性横断面研究评估了213例连续接受关节镜下肩袖修复手术的患者术前、术后1周、6周、12周和6个月时肩痛和手部麻木及刺痛的患病率和严重程度（通过改良的波士顿腕管综合征问卷中的两个问题进行评估）。
与术后6个月相比，术前休息、上举活动和睡眠期间肩痛的患病率和严重程度分别改善了52%、22%和34%（P<0.05）。75例患者（33%）术前报告有手部感觉异常。术后1周时，手部刺痛和麻木的严重程度分别降低了50%和60%（P<0.05）。术前手部麻木程度（Wald统计量；W=20）以及患者的肩部问题是否由特定损伤引起（W=6）可预测术后6个月时手部麻木的存在（P<0.05）。
本研究表明，许多接受肩袖修复手术的患者存在与肩痛相关的手部感觉异常。术后肩痛以及手部麻木和刺痛的患病率和严重程度均有所改善。
