Relationship Between Carpal Tunnel Syndrome and Wrist Angle in Computer Workers

腕隧道症候群是最常見的周邊神經壓迫病變，本研究的目的藉由理學檢查與神經傳導速度檢查的配合，來評估電腦工作者腕隧道症候群發生率。打電腦時手腕伸展的姿勢為可能造成腕隧道症候群危險因子之一，但其相關性迄今並無詳細研究。本研究調查南部某醫學中心的書記共45位（平均年齡38.8±7.8歲），工作時間每日超過6小時，每位受試者分別接受神經傳導檢查報告，並要求受試者填寫問卷，記錄個別的年齡，工作年資，慣用手，手掌麻痛的嚴重程度。再由醫師做相關理學檢查（Tinel’s sign 和 Phalen’s test），並測量受試者平時打電腦時手腕習慣放置的最大伸展角度，並由上述紀錄做進一步分析比較，結果顯示電腦工作者得到腕隧道症候群發生率約為16.7%，在符合腕隧道症候群判定標準的12名受試者中有7名患側在右手（優勢手），2名患側在左手，另有3名患者則是雙手同時發生，臨床症狀的嚴重度則與神經傳導檢查的異常程度相符合。在這些好發因子中，我們發現腕隧道症候群與打電腦時常維持的手腕角度大小成正相關，且手腕伸展超過20度以上較易造成腕隧道症候群的發生。

關鍵字

腕隧道症候群；電腦工作者；神經傳導速度檢查；手腕角度

並列摘要

Carpal tunnel syndrome (CTS) is the most widely known entrapment neuropathy. The aim of this study was to assess the incidence of CTS in a group of computer workers by typical symptoms, median nerve conduction studies, and their combinations. The posture of extended wrists while typing on a computer keyboard seems to be a predisposing factor for CTS. However, the correlation between wrist extension angle and the incidence of CTS is not well known. Forty-five subjects (mean age, 38.8 ± 7.8 years) who used a computer for more than 6 hours daily in a medical center in southern Taiwan were studied. All completed questionnaires to ascertain their age, employment duration, dominant hand, and the severity of symptoms. Physical examinations (Tinel’s sign and Phalen’s test) were performed by a physician. The maximal wrist extension angle when typing on a computer keyboard was also measured by the same physician. Nerve conduction studies were performed on each subject to determine the severity of CTS. Results showed that the incidence of CTS in the computer workers was 16.7% (15 of 90 hands). Twelve subjects showed electrodiagnostic evidence of CTS: it involved the dominant hand in seven, the non-dominant hand in two, and bilateral hands in three. The severity of clinical symptoms was compatible with the findings of the nerve conduction studies. Among the major predisposing factors, we found significant correlation between CTS development and the wrist extension angle while typing on a computer keyboard. Computer workers who kept their wrists extended by more than 20° were at greater risk of developing CTS.

並列關鍵字

carpal tunnel syndrome ； computer worker ； nerve conduction study ； wrist angle

國際替代計量

Relationship Between Carpal Tunnel Syndrome and Wrist Angle in Computer Workers

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