Nath Rahul K, Avila Meera B, Karicherla Priyanka, Somasundaram Chandra
Texas Nerve and Paralysis Institute, 6400 Fannin Street, Houston, Texas 77030, USA.
Open Orthop J. 2011;5:385-8. doi: 10.2174/1874325001105010385. Epub 2011 Dec 14.
The benefits of triangle tilt surgery in children with OBPI have been previously validated through measurements of statistical improvements in Mallet scores and in glenohumeral congruity. The purpose of the current study was to evaluate the effectiveness of triangle tilt surgery through the application of the Pediatric Outcomes Data Collection Instrument, a well validated questionnaire designed to evaluate function and comfort in children with musculoskeletal disorders.
OBPI patients between 2 and 10 years of age who came to our institute for routine office visits between May 2009 and October 2009 were considered to participate in the study. Among the patient group, the first 130 completed surveys who met the study criteria were included in the study. The Pediatric Outcomes Data Collection Instrument was completed by the parents of patients who have undergone triangle tilt surgery (Group 1: N=63) or those who were considered candidates for this procedure (Group 2: N=67). The results were compared between the two patient groups and analyzed using the unpaired student's t-test. Later, 23 patients from the group 2, underwent triangle tilt surgery (Group 3). We collected post-op data, compared and analyzed the outcome of the surgery in these patients to their own pre-op PODCI scores, using the paired student's t test.
In patients who have undergone triangle tilt surgery, significantly higher PODCI scores were observed in the parameters of upper extremity function (p<0.05), sports/physical function (p<0.05), basic mobility (p<0.0001) and global functioning (p<0.05), when compared to patients who have not undergone triangle tilt surgery. Further, PODCI scores in group 3 patients were significantly higher after surgery in the parameters of upper extremity function (p <0.03), Pain/Comfort (p <0.05), basic mobility (p<0.0002) and global functioning (p<0.03), when compared to before triangle tilt surgery.
The results of the Pediatric Outcomes Data Collection Instrument demonstrate the functional benefits of triangle tilt surgery in patients with obstetric brachial plexus injury.
三角倾斜手术对产瘫患儿的益处此前已通过对马利特评分及盂肱关节一致性的统计学改善测量得到验证。本研究的目的是通过应用儿科结局数据收集工具来评估三角倾斜手术的有效性，该工具是一个经过充分验证的问卷，旨在评估患有肌肉骨骼疾病儿童的功能和舒适度。
2009年5月至2009年10月间到我院进行常规门诊的2至10岁产瘫患者被纳入本研究。在患者组中，符合研究标准的前130名完成调查者被纳入研究。儿科结局数据收集工具由接受三角倾斜手术的患者（第1组：N = 63）或被视为该手术候选者的患者（第2组：N = 67）的父母完成。将两组患者的结果进行比较，并使用非配对学生t检验进行分析。之后，第2组中的23名患者接受了三角倾斜手术（第3组）。我们收集了术后数据，使用配对学生t检验将这些患者手术的结果与其术前的儿科结局数据收集工具评分进行比较和分析。
与未接受三角倾斜手术的患者相比，接受三角倾斜手术的患者在上肢功能（p < 0.05）、运动/身体功能（p < 0.05）、基本活动能力（p < 0.0001）和整体功能（p < 0.05）参数方面的儿科结局数据收集工具评分显著更高。此外，与三角倾斜手术前相比，第3组患者术后在上肢功能（p < 0.03）、疼痛/舒适度（p < 0.05）、基本活动能力（p < 0.0002）和整体功能（p < 0.03）参数方面的儿科结局数据收集工具评分显著更高。
儿科结局数据收集工具的结果证明了三角倾斜手术对产瘫性臂丛神经损伤患者的功能益处。
