Lurie Benjamin, Albanese Jessica, Allenback Gayle, Elliott Iain, Nelson Karen
Department of Orthopaedic Surgery, Kirk Kerkorian School of Medicine, University of Nevada Las Vegas, Las Vegas, Nevada.
Department of Orthopaedic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California.
JB JS Open Access. 2024 May 22;9(2). doi: 10.2106/JBJS.OA.23.00151. eCollection 2024 Apr-Jun.
Smaller hand size has been shown to affect ease of instrument use and surgeon injury rates in multiple surgical subspecialties. Women have a smaller average hand size and are more often affected by this issue than men. The goal of this resident survey was to investigate whether hand size and gender impact self-reported difficulty with instrument use among orthopaedic surgery residents.
Residents were surveyed about how often they experience difficulty using common orthopaedic instruments. Self-reported difficulty using surgical instruments was compared between residents with small glove (SG, outer ≤7.0) vs. large glove (LG, ≥ 7.5) sizes and between male and female residents.
One hundred forty-five residents (118 males and 27 females) completed the survey for a response rate of 3.7%. The SG group contained 35 residents, with 26 females and 9 males. The LG group contained 110 residents, with 1 female and 109 males. The SG group reported more difficulty than the LG group when using 3/6 instruments: the wire-cutting pliers (71.4% vs. 25.5%), universal T-handle chuck (65.7% vs. 21.4%), and large wire driver (60.0% vs. 24.8%). Female residents reported more difficulty than males for 5/6 instruments. Within the SG group, however, there was no difference in self-reported difficulty between female SG and male SG residents for 4/6 instruments.
The predominantly male LG group reported significantly less difficulty than the more gender mixed though still predominantly female SG group. A subanalysis comparing males and females within the SG group found that there was no difference between SG female and SG male residents for 4/6 of the instruments, suggesting that glove size might impact reported difficulty independently from gender. Although the effect of glove size vs. gender is difficult to differentiate in this study, the high rate of difficulty experienced by male and female residents in the SG group should be considered by residency programs, surgeon educators, and instrument manufacturers as the field of orthopaedic surgery continues to become more diverse.
III.
研究表明，手尺寸较小会影响多个外科亚专业中器械使用的便利性和外科医生的受伤率。女性的平均手尺寸较小，比男性更常受此问题影响。本次住院医师调查的目的是研究手尺寸和性别是否会影响骨科住院医师自我报告的器械使用困难程度。
对住院医师进行调查，询问他们使用常见骨科器械时遇到困难的频率。比较小手套尺寸（SG，外径≤7.0）与大手套尺寸（LG，≥7.5）的住院医师以及男性和女性住院医师自我报告的手术器械使用困难情况。
145名住院医师（118名男性和27名女性）完成了调查，回复率为3.7%。SG组有35名住院医师，其中26名女性和9名男性。LG组有110名住院医师，其中1名女性和109名男性。在使用3/6种器械时，SG组报告的困难程度高于LG组：钢丝钳（71.4%对25.5%）、通用T型手柄卡盘（65.7%对21.4%）和大型钢丝起子（60.0%对24.8%）。女性住院医师在5/6种器械上报告的困难程度高于男性。然而，在SG组内，4/6种器械的女性SG住院医师和男性SG住院医师在自我报告的困难程度上没有差异。
以男性为主的LG组报告的困难程度明显低于性别混合但仍以女性为主的SG组。对SG组内男性和女性进行的亚分析发现，4/6种器械的SG女性住院医师和SG男性住院医师之间没有差异，这表明手套尺寸可能独立于性别影响报告的困难程度。尽管在本研究中难以区分手套尺寸与性别的影响，但随着骨科手术领域的持续多元化，住院医师培训项目、外科教育工作者和器械制造商应考虑SG组中男性和女性住院医师经历的高困难率。
III级。
