Draviaraj Kingsley Paul, Chakrabarti Indranil
Department of Orthopaedics, Rotherham General Hospital, Rotherham, South Yorkshire, UK.
J Hand Surg Am. 2004 Sep;29(5):804-8. doi: 10.1016/j.jhsa.2004.05.005.
The purpose of this study was to assess the functional outcome after surgery for Dupuytren's contracture and the correlation between the change in the degree of deformity of the metacarpophalangeal joint (MCPJ) and the proximal interphalangeal joint (PIPJ) and the change in hand function.
Hand function in 30 patients was assessed by Sollerman hand function tests prospectively both before surgery and at 6 and 12 months after surgery. The deformity at the MCPJ and PIPJ was measured in degrees of angulation. The results were analyzed using the Spearman rank correlation test. In patients with multiple finger involvement the data were analyzed twice: first by using the measurements for the finger with the worst deformity and then repeating the analysis after the mean deformity was calculated.
The mean preoperative MCPJ and PIPJ deformity was 31 degrees (range, 30 degrees to 76 degrees ) and 35 degrees (range, 30 degrees to 96 degrees ), respectively. The mean correction at the MCPJ and PIPJ was 19.6 degrees and 16 degrees , respectively. The mean preoperative Sollerman score was 72.8, which improved to 77.9 at 12 months after surgery. There was a statistically significant correlation between the total correction, PIPJ correction, and hand function at 6 and 12 months, but not with MCPJ correction. In those patients with multiple finger involvement these correlations remained true regardless of whether the mean or greatest deformity was considered.
We conclude that improvement in deformity in Dupuytren's contracture leads to an improvement in hand function and that an improvement in the PIPJ contracture has a greater correlation with hand function than an improvement in the MCPJ contracture.
本研究旨在评估Dupuytren挛缩症手术后的功能结局，以及掌指关节（MCPJ）和近端指间关节（PIPJ）畸形程度的变化与手部功能变化之间的相关性。
前瞻性地通过Sollerman手部功能测试对30例患者术前以及术后6个月和12个月的手部功能进行评估。以角度测量MCPJ和PIPJ处的畸形。使用Spearman等级相关检验分析结果。对于多手指受累的患者，数据进行两次分析：首先使用畸形最严重手指的测量值，然后在计算平均畸形后重复分析。
术前MCPJ和PIPJ的平均畸形分别为31度（范围30度至76度）和35度（范围30度至96度）。MCPJ和PIPJ的平均矫正分别为19.6度和16度。术前Sollerman评分的平均值为72.8，术后12个月提高到77.9。在术后6个月和12个月时，总矫正、PIPJ矫正与手部功能之间存在统计学上的显著相关性，但与MCPJ矫正无关。在那些多手指受累的患者中，无论考虑平均畸形还是最大畸形，这些相关性均成立。
我们得出结论，Dupuytren挛缩症畸形的改善导致手部功能的改善，并且PIPJ挛缩的改善与手部功能的相关性比MCPJ挛缩的改善更大。
