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

2020 ◽  
pp. 229255032093369
Author(s):  
Ronit Wollstein ◽  
Dafna Michael ◽  
Hani Harel ◽  
Lois Carlson
Keyword(s):  
Wrist Fracture ◽  
Functional Evaluation ◽  
Dominant Hand ◽  
Hand Dominance ◽  
Radius Fractures ◽  
Results Of Treatment ◽  
Post Surgery ◽  
Time Period ◽  
Dominant Side ◽  
Little Finger

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.

scholarly journals The Effect of Hand Dominance on Functional Outcome Following Single Row Rotator Cuff Repair

2017 ◽  
Vol 11 (1) ◽  
pp. 562-566 ◽  
Author(s):  
Michael A. Kelly ◽  
Ciarán K. Mc Donald ◽  
Aidan Boland ◽  
Patrick J Groarke ◽  
Ken Kaar
Keyword(s):  
Rotator Cuff ◽  
Functional Outcome ◽  
Rotator Cuff Repair ◽  
Linear Regression Analysis ◽  
Outcome Data ◽  
Dominant Hand ◽  
Hand Dominance ◽  
Dominant Group ◽  
Cuff Repair ◽  
Dominant Side

Introduction: Rotator cuff tears are a common cause of shoulder disability and pain. Excellent outcomes can be obtained with surgical treatment although this outcome is affected by several factors. We sought to investigate the effect of hand dominance on subjective functional outcome post rotator cuff repair. Methods: All patients who had rotator cuff repair over a calendar year were identified and followed up at 3 years post operatively. Patients were consented for inclusion in the study and demographic data, hand dominance and functional outcome data was collected. L’insalata shoulder questionnaire was used for outcome data collection. SPSS version 22 was used for statistical analysis where appropriate. Results: 144 patients were included in this study. Mean age was 63 +/- 10.1 years in the dominant side group and 62 +/- 8.6 years in the non-dominant group. 92 patients had dominant side surgery and 52 had non-dominant side surgery. There was a statistically significant correlation between dominant hand and operated side (P=0.005). The mean overall outcome score was marginally higher in the dominant surgery group with a mean of 89.8 +/- 14.2 compared with a mean of 87.4 +/- 17.5 in the non-dominant group. Multi-variate linear regression analysis revealed this difference to be non-significant (p = 0.4). Conclusion: No difference was found in the functional outcome of rotator cuff repair between dominant and non-dominant side surgery. This information will help in counselling patients who are concerned about the potential impact of rotator cuff repair on the function of their dominant hand.

Predictors of Management of Distal Radius Fractures in Patients Aged >65 Years

Hand ◽  
2021 ◽  
pp. 155894472110172
Author(s):  
Amanda Walsh ◽  
Nelson Merchan ◽  
David N. Bernstein ◽  
Bailey Ingalls ◽  
Carl M. Harper ◽  
...  
Keyword(s):  
Distal Radius ◽  
Operative Management ◽  
Nonoperative Treatment ◽  
Distal Radius Fractures ◽  
Radius Fractures ◽  
Total N ◽  
Fracture Characteristics ◽  
Time Period ◽  
Tertiary Center ◽  
Comorbidity Index

Background Treatment of distal radius fractures (DRFs) in patients aged >65 years is controversial. The purpose of this study was to identify what patient and fracture characteristics may influence the decision to pursue surgical versus nonsurgical treatment in patients aged >65 years sustaining a DRF. Methods We queried our institutional DRF database for patients aged >65 years who presented to a single academic, tertiary center hand clinic over a 5-year period. In all, 164 patients treated operatively were identified, and 162 patients treated nonoperatively during the same time period were selected for comparison (total N = 326). Demographic variables and fracture-specific variables were recorded. Patient and fracture characteristics between the groups were compared to determine which variables were associated with each treatment modality (operative or nonoperative). Results The average age in our cohort was 72 (SD: 11) years, and 274 patients (67%) were women. The average Charlson Comorbidity Index (CCI) was 4.1 (SD: 2.1). The CCI is a validated tool that predicts 1-year mortality based on patient age and a list of 22 weighted comorbidities. Factors associated with operative treatment in our population were largely related to the severity of the injury and included increasing dorsal tilt (odds ratio [OR], 1.09; 95% confidence interval [CI], 1.05-1.12; P < .001) and AO Classification type C fractures (OR, 5.42; 95% CI, 2.35-11.61; P < .001). Increasing CCI was the only factor independently associated with nonoperative management (OR, 0.84; 95% CI, 0.72-0.997; P = .046). Conclusion Fracture severity is a strong driver in the decision to pursue operative management in patients aged >65 years, whereas increasing CCI predicts nonoperative treatment.

Fragment-specific fixation for complex intra-articular fractures of the distal radius: results of a prospective single-centre trial

2012 ◽  
Vol 37 (8) ◽  
pp. 765-771 ◽  
Author(s):  
A. S. Gavaskar ◽  
S. Muthukumar ◽  
N. Chowdary
Keyword(s):  
Distal Radius ◽  
Articular Surface ◽  
Distal Radius Fractures ◽  
First Year ◽  
Functional Evaluation ◽  
Radius Fractures ◽  
Articular Fractures ◽  
Functional Scores ◽  
Radial Length ◽  
Specific Fixation

The goal was to evaluate the efficacy of 2.4 mm column-specific plating for intra-articular distal radius fractures. In total, 105 patients with AO type C distal radius fractures were operated on using the locking distal radius system, Synthes. Follow-up assessments including clinical (wrist and forearm range of motion, grip strength), radiological (articular step, radial length and inclination, volar tilt, and ulnar variance), and functional scores (Disabilities of the Arm, Shoulder, and Hand; Patient Rated Wrist Evaluation) were made at regular intervals until 1 year. Union was obtained in all patients. Articular surface was anatomically reconstructed in 74 patients (70.5%). Clinical and functional evaluation showed significant continuous improvements over the first year. C1 fractures had a better chance of anatomical reduction compared with C2 and C3 fractures. Fracture type, quality of reduction, and presence of degenerative changes did not show a significant effect on functional outcome scores. Column-specific fixation of the distal radius can achieve satisfactory results in complex intra-articular fractures.

scholarly journals FREQUENCY, DISTRIBUTION AND TREATMENT OF ACUTE FLEXOR TENDON INJURIES IN ZONE V OF HAND

2019 ◽  
Vol 17 (1) ◽  
pp. 11-14
Author(s):  
Muhammad Shafiq
Keyword(s):  
Median Nerve ◽  
Frequency Distribution ◽  
Radial Artery ◽  
Flexor Tendon ◽  
Tendon Injuries ◽  
Dominant Hand ◽  
Mechanism Of Injury ◽  
Results Of Treatment ◽  
Wound Size ◽  
Flexor Tendon Injuries

Background: Flexor tendons injuries are common emergency procedures The objectives of this study were to determine the frequency, distribution and results of treatment of acute flexor tendon injuries in zone V of hand in our population. Material and Methods: This descriptive cross-sectional was conducted in the Department of Orthopedic, Gomal Medical College, D.I.Khan, Pakistan from January 2015 to December 2017. Sample size was 30, selected through consecutive technique. Patients having flexor tendon injuries in zone v, admitted through emergency department were included in this study. Demographic variable were sex and age-groups. The research variable were tendon involved, nerves involved, artery involved, mechanism of injury, wound size, duration of injury, season, type of injury, hand involved and results of treatment. All variables, being categorical were analyzed by frequency and percentages using SPSS version 16.0. Results: Out of 30 patients, 22(73.33%) were male. Twenty four (80%) patients were between 21 to 40 years age. Mechanism of injury was glass in 16(53.33%) cases, knife in 10(33.33%) cases. Twenty (66.66%) cases presented in summer. Flexor digitorum sublimus was injured in 21(70.0%), FCR in 11(36.66%), FPL in 8(26.66), FDP in 6(20.0%) and FCU in 4(13.33%) cases. Median nerve was involved in nine (30%) cases. Radial artery was involved in eight (26.66%) cases. Wound size was 2 cm in 24(80%) cases. Sixteen (53.33 %) cases came with self-inflicted injuries. Twenty (66.66 %) cases came after 12 hours. Twenty five (83.33%) patients achieved good to excellent results. Conclusion: Flexor digitorus sublimus was the most common tendon injured in non-dominant hand, especially in young males. Median nerve and radial artery were commonly injured structures mostly with glass. Majority patients presented more than 12 hours after injury, having wound size of 2cm. Mostly the injuries were self-inflicted and occurred in summer season.

scholarly journals Impact of symptom bilaterality and hand dominance on patient-reported disability outcomes

2018 ◽  
Vol 6 ◽  
pp. 205031211879756
Author(s):  
Helen Razmjou ◽  
Tim Dwyer ◽  
Richard Holtby
Keyword(s):  
Risk Factors ◽  
Rotator Cuff ◽  
Outcome Measures ◽  
Rotator Cuff Tear ◽  
Glenohumeral Joint ◽  
Impingement Syndrome ◽  
Older Age ◽  
Hand Dominance ◽  
Cuff Tear ◽  
Dominant Side

Objectives: It is not clear if using patients with bilateral symptoms would impact the level of disability reported in orthopaedic research. The purposes of this study were to (1) examine the prevalence of bilateral shoulder symptoms (significant pain, stiffness or weakness affecting function) in patients with rotator cuff impingement syndrome, rotator cuff tear and osteoarthritis of the glenohumeral joint, (2) explore risk factors associated with bilateral shoulder symptoms, and (3) examine the impact of symptom bilaterality and hand dominance on pre- and post-operative patient-oriented disability outcomes. Methods: This study involved secondary analysis of prospectively collected data of patients who had undergone shoulder surgery and had returned for their 1-year follow-up. Two outcome measures were collected prior to surgery and at 1-year following surgery: the American Shoulder and Elbow Surgeons and the Constant–Murley Score. Results: Data of 772 patients, 376 (49%) females, 396 males (51%); 288 (impingement syndrome), 332 (rotator cuff tear), and 152 (osteoarthritis) were included in the analysis. There was a statistically significant difference in the prevalence of bilateral symptoms being 44%, 28%, and 22% in the osteoarthritis, impingement syndrome, and rotator cuff tear groups, respectively (p < 0.0001). The prevalence of dominant side involvement was 71%, 67%, and 53% in the rotator cuff tear, impingement syndrome, and osteoarthritis groups (p < 0.0001). Older age and female sex were risk factors for development of bilateral symptoms only in patients with rotator cuff tear. Neither symptom bilaterality nor dominant arm involvement had a negative impact on patient-oriented disability outcome measures prior to or after surgery (p > 0.05). Conclusion: This study shows that patients with osteoarthritis of the glenohumeral joint have the highest prevalence of bilateral shoulder complaints. The older age and the female sex increased the risk of having bilateral symptoms in patients with rotator cuff tear. Having bilateral shoulder symptoms or dominant side involvement was not associated with higher level of disability prior or after surgery.

Evaluation of Hand-Dominance on Manual Control of Aircraft

1996 ◽  
Vol 40 (2) ◽  
pp. 72-76 ◽  
Author(s):  
Valerie J. Gawron ◽  
James E. Priest
Keyword(s):  
Manual Control ◽  
Dominant Hand ◽  
Hand Dominance ◽  
Transport Aircraft ◽  
Left Hand ◽  
Tracking Tasks ◽  
Right Hand ◽  
Hand Control ◽  
Left And Right ◽  
Task Simulation

In the transport aircraft community the non-dominant hand control of aircraft is the norm. This historical precedence may be biasing the cockpit designs of the newer fly-by-wire aircraft which utilize a small sidestick controller rather than a wheel-column. Very little data are available to determine what effect non-dominant hand control using small throw controllers has on the pilot operator. To provide such data, a part-task simulation study was undertaken. Three different compensatory tracking tasks were performed with both left and right hand-controllers. Six right-hand dominant and three left-hand dominant subjects performed all three tasks, with both controllers. The results indicate that performance degraded and workload increased when the pilots were forced to use their non-dominant hand.

scholarly journals Impact of hand dominance on effectiveness of chest compressions in a simulated setting: a randomised, crossover trial

2019 ◽  
Vol 16 ◽  
Author(s):  
Jamie Cross ◽  
Tommy Lam ◽  
Joel Arndell ◽  
John Quach ◽  
Buck Reed ◽  
...  
Keyword(s):  
Primary Outcome ◽  
Crossover Trial ◽  
Recovery Period ◽  
Outcome Data ◽  
Dominant Hand ◽  
Hand Dominance ◽  
Modest Improvement ◽  
Significant Difference ◽  
Secondary Outcomes ◽  
The Impact

Aim External cardiac compressions (ECC) are a critical component in determining the effectiveness of cardiopulmonary resuscitation (CPR). Guidelines prior to the 2010 International Liaison Committee on Resuscitation directed rescuers to place the heel of the dominant hand directly on the chest when performing ECC, however current guidelines are silent on this issue. Existing research is inconsistent in findings, and heterogeneous in design and participants. The aims of this pilot study were to: 1) investigate the impact of hand dominance on effectiveness of ECC; and 2) generate outcome data to inform sample size calculations for a larger future study.Methods This study utilised a single blinded, prospective randomised crossover trial design. Each participant was allocated to a ‘dominant hand on chest’ (DHOC) or ‘non-dominant hand on chest’ (NDHOC) group. On a simulation manikin, participants in the DHOC group performed 3 minutes of ECC with dominant hand on the chest and non-dominant hand supporting, followed by a ‘rest and recovery’ period and then a second 3-minute period of ECC with the hand reversed such that the non-dominant hand was on the chest. The NDHOC group performed the same series of compressions but in reverse order. The primary outcome measure was effectiveness of ECC, determined by a percentage-based ‘CPR score’ (‘CS’). Secondary outcomes were compression depth, rate and release. The Wilcoxon rank-sum (Mann-Whitney) test was used due to the non-normal distribution of the data. Due to the crossover design, hierarchical linear regression was used to assess for a period or cross over effect. Results For the primary outcome of this study, we have found no significant difference in CS between DHOC and NDHOC (69.9% (SD=29.9) vs. 69.1% (SD=34.1); p=0.92), respectively. There were no differences in the secondary outcomes of compression rate and depth, though compression release was improved in the DHOC group (53% vs. 42%; p=0.02).ConclusionIn this randomised crossover study conducted in a simulation context there was no difference in ECC effectiveness measured by an overall effectiveness outcome according to placement of the dominant or non-dominant hand on the chest during compressions. A modest improvement in ECC release was seen in the dominant hand on chest group. While the study was underpowered, the results support an approach involving rescuers placing whichever hand they are most comfortable with on the chest irrespective of handedness.

scholarly journals Inter-personal motor interaction is facilitated by hand pairing

2022 ◽  
Vol 12 (1) ◽  
Author(s):  
Keivan Mojtahedi ◽  
Kimia Kiani ◽  
Marco Santello ◽  
Qiushi Fu
Keyword(s):  
Single Agent ◽  
Internal Force ◽  
Vertical Movement ◽  
Movement Speed ◽  
Dominant Hand ◽  
Hand Dominance ◽  
Haptic Communication ◽  
Human Participants ◽  
Movement Synchrony ◽  
First Time

AbstractThe extent to which hand dominance may influence how each agent contributes to inter-personal coordination remains unknown. In the present study, right-handed human participants performed object balancing tasks either in dyadic conditions with each agent using one hand (left or right), or in bimanual conditions where each agent performed the task individually with both hands. We found that object load was shared between two hands more asymmetrically in dyadic than single-agent conditions. However, hand dominance did not influence how two hands shared the object load. In contrast, hand dominance was a major factor in modulating hand vertical movement speed. Furthermore, the magnitude of internal force produced by two hands against each other correlated with the synchrony between the two hands’ movement in dyads. This finding supports the important role of internal force in haptic communication. Importantly, both internal force and movement synchrony were affected by hand dominance of the paired participants. Overall, these results demonstrate, for the first time, that pairing of one dominant and one non-dominant hand may promote asymmetrical roles within a dyad during joint physical interactions. This appears to enable the agent using the dominant hand to actively maintain effective haptic communication and task performance.

scholarly journals Volar locking plate versus external fixation in distal radius fractures: A meta-analysis

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Giuseppe Maccagnano ◽  
Giovanni Noia ◽  
Giovanni Vicenti ◽  
Marco Baglioni ◽  
Maria Rosa Masciale ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Distal Radius ◽  
Systematic Reviews ◽  
External Fixator ◽  
Meta Analysis ◽  
A Priori ◽  
Wrist Fracture ◽  
Distal Radius Fractures ◽  
Radius Fractures

The purpose of this meta-analysis is to evaluate the efficacy of plate or external fixator treatments in distal radius fractures, based not only on clinical and radiographic parameters but on Health Related Quality of Life (HRQOL) parameters. The Preferred Reporting Items for Systematic Reviews and Metanalyses (PRISMA) guidelines were followed when conducting this systematic review. The Revised Assessment of Multiple Systematic Reviews (RAMSTAR) checklist was additionally consulted in order to ensure a high-quality methodological process, encompassing such elements as an ‘a priori’ design, independent reviews and comprehensive search. The literature search was carried out on PubMed, MEDLINE and Scopus. The search terms used were “Radius fracture AND osteosynthesis”, “Wrist fracture AND external fixator” and “Wrist fracture AND plate”. Two reviewers independently screened titles, abstracts and full texts. To determine inter-reviewer agreement, a k score was calculated after each screening state. Of the 5753 studies collected through the initial databases search, two studies were included in the final meta-analysis (125 treated with external fixator vs 132 with volar plate). There was a substantial inter-reviewer agreement as to the title (0.73; 95% confidence interval, 0.67-0.79) abstract (0.65; 95% CI, 0.46-0.83) and fulltext screening stages (0.89; 95%CI, 0.67-1). The meta-analysis reported a mean difference equal to 0.00 (95%CI= -0.05 – 0.05), in accordance with I2= 0% and p test for the heterogeneity value=0.089. This meta analysis confirms and quantifies that the two techniques are superimposable as regards the quality of life reported by patients at least one year of follow-up.

scholarly journals A Systematic Comparison of Perceptual Performance in Softness Discrimination with Different Fingers

2020 ◽  
Vol 82 (7) ◽  
pp. 3696-3709
Author(s):  
Aaron C. Zoeller ◽  
Knut Drewing
Keyword(s):  
Ring Finger ◽  
Middle Finger ◽  
Dominant Hand ◽  
Sensory Sensitivities ◽  
Motor Abilities ◽  
Soft Objects ◽  
Perceptual Performance ◽  
Improved Performance ◽  
Spontaneous Exploration ◽  
Little Finger

Abstract In studies investigating haptic softness perception, participants are typically instructed to explore soft objects by indenting them with their index finger. In contrast, performance with other fingers has rarely been investigated. We wondered which fingers are used in spontaneous exploration and if performance differences between fingers can explain spontaneous usage. In Experiment 1 participants discriminated the softness of two rubber stimuli with hardly any constraints on finger movements. Results indicate that humans use successive phases of different fingers and finger combinations during an exploration, preferring index, middle, and (to a lesser extent) ring finger. In Experiment 2 we compared discrimination thresholds between conditions, with participants using one of the four fingers of the dominant hand. Participants compared the softness of rubber stimuli in a two-interval forced choice discrimination task. Performance with index and middle finger was better as compared to ring and little finger, the little finger was the worst. In Experiment 3 we again compared discrimination thresholds, but participants were told to use constant peak force. Performance with the little finger was worst, whereas performance for the other fingers did not differ. We conclude that in spontaneous exploration the preference of combinations of index, middle, and partly ring finger seems to be well chosen, as indicated by improved performance with the spontaneously used fingers. Better performance seems to be based on both different motor abilities to produce force, mainly linked to using index and middle finger, and different sensory sensitivities, mainly linked to avoiding the little finger.

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