Hand laterality recognition in distal radius and/or ulna fracture

• Published in: Journal of hand therapy Vol. 35; no. 2; pp. 282 - 288
• Main Authors: Geete, Dipti Baban, Mehta, Pratha Umesh, Dewan, Neha, Mehta, Amita Anil
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-04-2022; Elsevier Limited
• Subjects: Accuracy; Closed reduction; Diabetic neuropathy; Distal Radius and/or Ulna fracture; Fractures; Hand laterality; Immobilization; Injuries; Limbs; Mental task performance; Motor imagery; Orientation behavior; Pain; Patients; Plasters; Rehabilitation; Response time; sensorimotor representation; Statistical analysis; Trauma; Ulna; Upper limb immobilization; Variance analysis; Visual tasks; Hand laterality; Motor imagery; sensorimotor representation; Upper limb immobilization; Distal Radius and/or Ulna fracture
• ISSN: 0894-1130; 1545-004X
• DOI: 10.1016/j.jht.2022.01.003

•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.
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.
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.
Prospective cross sectional study.
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.
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.
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.