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American Association for Hand Surgery
Meeting Home Accreditation Final Program
Theme: Inclusion and Collaboration Theme: Inclusion and Collaboration

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Does Hand Swelling Occur Overnight?
William J Warrender, MD: Peter P. Pham, MS, Cynthia Watkins, OT, DPT, CHT; Harold Salmons, BS; Michael Rivlin, MD
Thomas Jefferson University, Philadelphia, PA


The goal of this study was to quantify the variation in daily hand volume that is expected in the normal hand. Our hypothesis is that hand swelling occurs overnight.


Hand volume measurements of 36 healthy volunteers with no known active hand pathology were taken daily at 8a, 2p and 8p over a three-day period. Demographic information, co-morbid conditions and previous hand pathology was recorded for each subject. Subjects were blinded to the objectives of the study. Statistical analysis was performed to determine if any of the time points or patient demographics were associated with an increased change in hand volume.


Thirty-six healthy volunteers with a mean age of 40.78 and mean body mass index (BMI) of 24.18 kg/m2 were enrolled. Twenty-one volunteers were male and 15 were female. Three of the volunteers were left handed. Mean hand volume decreased by 2.71% (13.11ml, p<0.0001) from the morning to the afternoon and again by 1.65% (7.79ml, p<0.0001) from the afternoon to the evening. There was a mean increase of 4.32% (20.90ml, p<0.0001) overnight from the evening to the morning. There was no significant difference across the three days. Age, gender, and BMI were not associated with increased changes in hand volume.


Physiologic hand swelling occurs overnight. Further investigation is needed to elucidate the etiology of nighttime sleep disturbance related these findings and how this translates to specific disease processes and the post surgical course.

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