Cizmar Igor, Zalesak Bohumil, Pilny Jaroslav, Drac Pavel, Fialova Jana
Department of Traumatology, University Hospital Olomouc, Czech Republic.
Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2006 Nov;150(2):313-9. doi: 10.5507/bp.2006.048.
The aim of the work is to objectify the functional effectiveness of these operations and their influence on the quality of life of handicapped patients.
The authors evaluate the results of reconstructive surgery restoring hand grip in a group of 15 tetraplegic patients (3 women and 12 men) with complete spinal cord lesion of C5-C7 segments. The average age of patients in the group is 33 (22-50) years old. The reconstructions were performed using tendon transfer and tenodesis in the forearm and hand area. The effectiveness of the transfer was assessed objectively with regard to muscle strength by measuring the restored "thumb-index finger" grip and "into fist" grip. The range of motion achieved was also evaluated. Transfer effectiveness was evaluated on the basis of subjective patients' evaluation. An ADL (activities of daily living) questionnaire by Mohammed's (1992) took into account the effect of the surgery in a whole range of common daily activities.
An extended range of daily activities was evident mainly in the fields of: communication, eating and drinking and operations associated with increase in general selfcare of the patient. There was no deterioration of condition in any of the activities.
Up to 80 % of tetraplegic patients are suitable candidates for transfers and, to a certain extent, it is possible to improve the upper limb function. In a partial function restoration of the upper limbs there is immense potential for improvement in the quality of life of these patients.
本研究旨在客观评估这些手术的功能效果及其对残疾患者生活质量的影响。
作者评估了15例C5 - C7节段完全性脊髓损伤的四肢瘫痪患者（3名女性和12名男性）进行恢复握力的重建手术的结果。该组患者的平均年龄为33岁（22 - 50岁）。重建手术在前臂和手部区域采用肌腱转移和腱固定术进行。通过测量恢复的“拇指 - 示指”握力和“握拳”握力，从肌肉力量方面客观评估转移的有效性。还评估了所达到的活动范围。根据患者的主观评价评估转移效果。穆罕默德（1992年）的日常生活活动（ADL）问卷考虑了手术在一系列常见日常活动中的效果。
日常活动范围的扩大主要体现在以下方面：沟通、饮食以及与患者总体自我护理能力提高相关的活动。在任何一项活动中病情均未恶化。
高达80%的四肢瘫痪患者适合进行肌腱转移手术，并且在一定程度上可以改善上肢功能。在上肢部分功能恢复方面，这些患者的生活质量有极大的改善潜力。
