Talk Through the Hand: Upper-Extremity Injury and Surgical Considerations in Sign Language Users

Area of Science:

• Medicine
• Orthopedics
• Audiology

Background:

• Sign language is a primary nonverbal communication method in the US, used by 7 million people.
• One million national sign language users are deaf or hard-of-hearing and rely heavily on upper extremities.
• Extensive long-term use of sign language can lead to upper-extremity impairments.

Purpose of the Study:

• To highlight the vulnerability of sign language users to upper-extremity impairment.
• To emphasize the importance of preserving upper-extremity mobility for communication.
• To guide hand surgeons in selecting treatments that minimize communication disruption for sign language users.

Main Methods:

• This article reviews clinical considerations for hand surgeons.
• It synthesizes existing knowledge on sign language use and upper-extremity health.
• No new clinical data was generated; this is a review and guidance piece.

Main Results:

• Sign language users face unique challenges regarding upper-extremity health.
• Impaired hand and arm function directly impacts communication ability.
• Careful surgical planning is crucial to maintain functional communication.

Conclusions:

• Hand surgeons must prioritize communication maintenance in deaf and hard-of-hearing patients undergoing treatment.
• Understanding the biomechanics of sign language is essential for appropriate clinical decision-making.
• This article provides a framework for managing upper-extremity conditions in sign language communicators.