Mendes Ribeiro Rui André, Moreira Salomé, Teófilo Vanessa, Pinelas Sofia, Miller Mariana, Pinho Paulo, Norton Pedro, Amorim Nelson, Serdoura Francisco, Vidinha Vítor
Occupational Health Service of Porto Hospital and University Center, Porto, Portugal.
Orthopedics and Traumatology Service of Porto Hospital and University Center, Porto, Portugal.
Med Lav. 2025 Jun 17;116(3):16161. doi: 10.23749/mdl.v116i3.16161.
Osteoarthritis of the trapeziometacarpal joint (rhizarthrosis) is one of the most frequent causes of hand dysfunction. Its significant impact on daily activities and work tasks is evident. This clinical condition is more commonly associated with older age, predominantly affects females, and is often linked to repetitive movements and heavy manual labor. Therefore, it is crucial to focus on the prevention and early intervention of this pathology to minimize its impact not only on worker's health but also on their professional performance. This article aims to critically examine the association between rhizarthrosis, namely the pain with these conditions and its influence on work capacity.
An epidemiological survey was conducted on active workers diagnosed with symptomatic rhizarthrosis who underwent surgical treatment. Data collected included gender, age, dominant hand, labor intensity scale, radiological classification of rhizarthrosis, patient-reported pain classification, and work capacity before and after surgical intervention.
In this study, there was a higher prevalence among females and older individuals. More advanced radiological classifications of rhizarthrosis did not correlate with more advanced pain classifications; however, statistically significant differences were found in higher work disability. Jobs requiring higher labor intensity and greater hand use were significantly associated with higher pain levels, increased work disability, and elevated radiological classifications of rhizarthrosis according to the Eaton and Littler scale.
Patients with rhizarthrosis surgically treated showed a statistically significant reduction in reported pain on the analog scale, as well as greater work capacity after surgical intervention, thus contributing to better professional performance.
大多角掌关节骨关节炎（拇指腕掌关节病）是手部功能障碍最常见的原因之一。其对日常活动和工作任务的重大影响显而易见。这种临床病症更常见于老年人，主要影响女性，并且常与重复性动作和繁重体力劳动有关。因此，关注这种病症的预防和早期干预至关重要，这不仅能将其对工人健康的影响降至最低，还能减少对其工作表现的影响。本文旨在批判性地研究拇指腕掌关节病，即疼痛与这些病症之间的关联及其对工作能力的影响。
对确诊患有症状性拇指腕掌关节病并接受手术治疗的在职工人进行了一项流行病学调查。收集的数据包括性别、年龄、优势手、劳动强度量表、拇指腕掌关节病的放射学分类、患者报告的疼痛分类以及手术干预前后的工作能力。
在本研究中，女性和老年人的患病率较高。拇指腕掌关节病更高级的放射学分类与更严重的疼痛分类无关；然而，在更高的工作残疾率方面发现了统计学上的显著差异。根据伊顿和利特勒量表，需要更高劳动强度和更多手部使用的工作与更高的疼痛水平、工作残疾增加以及拇指腕掌关节病更高的放射学分类显著相关。
接受手术治疗的拇指腕掌关节病患者在视觉模拟量表上报告的疼痛有统计学上的显著减轻，并且手术干预后工作能力更强，从而有助于提高职业表现。
