나르히

Purpose The aim of this study was to evaluate the role of quantitatively assessed bone SPECT/CT parameters for predicting the success of conservative treatment for symptomatic basal joint arthritis of the thumb. Patients and Methods Seventy-eight patients (128 hands) with symptomatic basal joint arthritis of the thumb who underwent bone SPECT/CT scans within 4 weeks after their initial visit and completed conservative treatment for more than 6 months between April 2019 and April 2023 were retrospectively enrolled. PRWHE (patient-rated wrist/hand evaluation) was evaluated in all patients before and after the treatment. The SUVmax from bone SPECT/CT was measured in the 4 peritrapezial joints, and the highest uptake was used for analysis. Results On the basis of the minimal clinically important difference in PRWHE scores, 64 hands (50.0% of 128 hands) were classified as the treatment success group and 64 hands (50.0% of 128 hands) were failure group. In multivariate logistic regression analysis, only high SUVmax (odds ratio, 1.097; 95% confidence interval, 1.027–1.172; P = 0.006) was a factor significantly associated with the success of conservative treatment. In receiver operating characteristics curve analysis, the area under the curve of SUVmax was 0.649 (95% confidence interval, 0.554–0.744; P = 0.002). As a prognostic parameter for the success of conservative treatment, SUVmax showed a sensitivity of 56.3% and specificity of 70.3% with a cutoff of 9.52. Conclusions High initial SUVmax on bone SPECT/CT was significantly associated with the success of conservative treatment for symptomatic basal joint arthritis of the thumb.

Background: This study aimed to evaluate the influence of physical performance level on patient-reported outcomes after surgery for distal radius fractures (DRF). Methods: We retrospectively reviewed 157 women with DRF who underwent surgery and completed the short physical performance battery (SPPB) within one month of trauma between January 2019 and August 2022. Patient-reported outcomes were assessed one year postoperatively using the disabilities of the arm, shoulder, and hand (DASH) and patient-rated wrist evaluation (PRWE) questionnaires. Multivariate linear regression analysis was conducted using patient characteristics, fracture type, treatment-related factors, and SPPB results to evaluate the factors associated with patient-reported outcomes. Results: Multivariate linear regression model revealed that dominant hand involvement (B=7.329; 95% confidence interval [CI], 2.901–11.757; P=0.001) and lower SPPB scores (B=-2.145; 95% CI, -3.194 to -1.096; P<0.001) were significantly associated with higher DASH and PRWE scores. Conclusions: Physical performance level evaluated using the SPPB was significantly associated with poor clinical outcomes of DRF after surgery. Physicians should implement a systematic approach to enhance physical performance along with appropriate fracture treatment to improve clinical outcomes following surgery for DRF.