Department of Rehabilitation and Hand Surgery, Nagato General Hospital, Nagato, Japan.
J Hand Surg Asian Pac Vol. 2023 Feb;28(1):53-60. doi: 10.1142/S242483552350008X. Epub 2023 Feb 20.
The carpometacarpal (CMC) joint of the thumb is the second most common site of osteoarthritis in the hand. Clinical severity stage of CMC joint arthritis has not been correlated with the pain level of the patient. Recently, the association of joint pain with patient psychological factor, such as depression or case-specific personality, has been investigated. This study was designed to determine the impact of psychological factors to residual pain after treatment of CMC joint arthritis, using pain catastrophizing scale (PCS) and the Yatabe-Guilford (YG) personality test. Twenty-six patients (7 males and 19 females) with 26 hands were included. Thirteen patients classified as Eaton stage 3 underwent suspension arthroplasty and 13 patients as Eaton stage 2 underwent conservative treatment using a custom fitted orthosis. Clinical evaluation was assessed using Visual Analogue Scale (VAS) and the quick Disabilities of the Arm, Shoulder and Hand Questionnaire Score (QuickDASH) at initial evaluation, at 1 month and at 3 months after treatment. We compared both groups using the PCS and YG test. The PCS showed significant difference in the VAS scores only at initial evaluation in both surgical and conservative treatment. There was a significant difference in VAS at 3 months between the two groups in both surgical and conservative treatment and in QuickDASH at 3 months in conservative treatment. The YG test has been used mainly in psychiatry. Although this test has not yet been used worldwide, its usefulness has been recognised and applied clinically, especially in Asia. Patient characteristics are strongly associated with residual pain of the CMC joint arthritis of the thumb. The YG test is a useful tool to analyse pain-related patient characteristics and can be utilised to determine the therapeutic modalities and most effective rehabilitation programme for pain control. Level III (Therapeutic).
拇指腕掌（CMC）关节是手部第二常见的骨关节炎部位。CMC 关节关节炎的临床严重程度阶段与患者的疼痛水平没有相关性。最近，已经研究了关节疼痛与患者心理因素（如抑郁或特定人格）的关系。本研究旨在使用疼痛灾难化量表（PCS）和八尾-圭尔福德（YG）人格测试来确定心理因素对 CMC 关节关节炎治疗后残留疼痛的影响。
纳入了 26 名患者（7 名男性和 19 名女性）的 26 只手。13 名患者 Eaton 分期 3 期行悬吊关节成形术，13 名患者 Eaton 分期 2 期行定制矫形器保守治疗。临床评估采用视觉模拟评分（VAS）和快速上肢肩手问卷评分（QuickDASH）在初始评估、治疗后 1 个月和 3 个月进行评估。我们使用 PCS 和 YG 测试对两组进行比较。
PCS 在手术和保守治疗的初始评估时仅在 VAS 评分上有显著差异。在手术和保守治疗中，两组在治疗后 3 个月的 VAS 评分和保守治疗中 3 个月的 QuickDASH 评分上均有显著差异。
YG 测试主要用于精神病学。尽管该测试尚未在全球范围内使用，但它的有效性已得到认可并在临床上得到应用，尤其是在亚洲。患者特征与拇指 CMC 关节关节炎的残留疼痛密切相关。YG 测试是分析与疼痛相关的患者特征的有用工具，可以用于确定治疗方式和最有效的康复方案以控制疼痛。
III 级（治疗）。
