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Hand laterality recognition in distal radius and/or ulna fracture

Published:February 25, 2022DOI:https://doi.org/10.1016/j.jht.2022.01.003

      Highlights

      • The post-immobilization sequelae are pain, local motor changes and central changes.
      • Immobilization post fracture can induce changes in sensory and motor cortical areas causing modification of sensorimotor memories.
      • Implicit memory affects after 4-6 weeks of Immobilization.

      ABSTRACT

      Introduction

      Hand laterality, an important ability to determine the orientation of a limb is common to get affected after short term immobilization. Distal radius and/or ulna fracture is a commonly encountered fracture resulting from upper-limb trauma. Conservative treatment using closed reduction and plaster cast application to immobilize the joint remains choice of treatment over surgery in the treatment of these fractures. There is a paucity of literature reporting impairment in hand laterality after long term immobilization as commonly performed in patients with distal radius and/or ulna fractures. Understanding effect of immobilization on hand laterality in distal-end radius/ulna fractures warranted present investigation.

      Purpose

      To evaluate hand laterality based on the accuracy and response time for hand determination after plaster cast removal in distal radius and/or ulna fracture.

      Study design

      Prospective cross sectional study.

      Methodology

      Subjects (n = 60, age range = 40-59 years, females (n) = 28 and males (n) = 32) were shown 24 real-hand images with various degrees of angular rotation and instructed to identify the hand as left and/or right. Accuracy (% correctly identified) and Response time (milliseconds to identify left or right hand in the image) of motor imagery during hand laterality task were recorded. Pain intensity before and after the hand laterality task were noted using Visual Analogue Scale. Repeated measures of ANOVA and t tests were used to analyze the accuracy and response times among two groups.

      Results

      The experimental group showed significantly (P < .05) lower accuracy and longer response time as compared to the control group. No significant difference in the accuracy and response time were noted in the immobilization of the dominant and the non-dominant hand within the experimental group (P > .05). Also, there was no change in pain pre- to post-hand laterality task.

      Conclusion

      Findings of this study could aid in enhancing the understanding of post-immobilization effect on hand laterality and open new arenas for assessment and rehabilitation of distal-end radius and/or ulna fractures where immobilization is the principal treatment.

      Keywords

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      JHT Read for Credit

      Quiz: # 849

      Record your answers on the Return Answer Form found on the tear-out coupon at the back of this issue or to complete online and use a credit card, go to JHTReadforCredit.com. There is only one best answer for each question.
      • # 1.
        The focus of the study was
        • a.
          to define hand laterality for therapists unfamiliar with the term
        • b.
          to determine if hand laterality is more accurate in right-handed subjects
        • c.
          to describe a treatment protocol for patients suffering diminished hand laterality
        • d.
          the effect of immobilization on hand laterality
      • # 2.
        The authors defined hand laterality as
        • # a.
          the subject's dominant hand
        • b.
          the subject's non-dominant hand
        • c.
          the ability to correctly identify an image of a hand shown to the subject as a right or left hand
        • d.
          the ability to switch dominance following injury
      • # 3.
        The experimental group was comprised of
        • a.
          patients following DRFx or distal ulna Fx treated with plaster immobilization
        • b.
          patients following DRFx or distal ulna Fx treated with pins and plaster immobilization
        • c.
          patients following DRFx or distal ulna Fx treated with ORIF
        • d.
          student volunteers who were immobilized with plaster casts
      • # 4.
        Centrally mediated dysfunction can be assessed by
        • a.
          MRI
        • b.
          GMI
        • c.
          PET scan
        • d.
          X-ray
      • # 5.
        The experimental group demonstrated less accuracy and slower response times than the control group
        • a.
          not true
        • b.
          true
      When submitting to the HTCC for re-certification, please batch your JHT RFC certificates in groups of 3 or more to get full credit.