Thabet Ahmed M, Kowtharapu Durga Nagaraju, Miller Freeman, Dabney Kirk W, Shah Suken A, Rogers Kenneth, Holmes Laurens
Department of Orthopedics, Alfred I. duPont Hospital for Children, Nemours Children's Clinic, 1600 Rockland Road, Wilmington, DE 19803, USA.
Musculoskelet Surg. 2012 Dec;96(3):199-204. doi: 10.1007/s12306-012-0217-0. Epub 2012 Aug 15.
We report clinical and radiographic outcomes of wrist fusion achieved with pin or plate fixation in 14 patients with severe quadriplegic cerebral palsy (CP) (19 wrists). Average patient age at the time of surgery was 16.8 ± 1.7 years (14-20 years). Mean follow-up time for the 14 patients was 5.9 ± 3.1 years (range, 1-11 years). Indication for surgery was severe wrist deformity that interfered with hygienic care. Few complications occurred, and outcomes were satisfactory. Statistically significant mean difference was shown between the pre- and postoperative radiographic angles (37°, P = 0.001, and 24°, P = 0.04, for lateral and anteroposterior views, respectively). Caregivers reported that appearance was the most perceived rationale for surgery (63 %). Improved hygienic care was the primary perceived benefit. The majority (88 %) were satisfied with the results. We recommend wrist fusion to improve hygienic care, positioning, and appearance of the wrist, hand, and fingers in patients with severe quadriplegic CP.
我们报告了14例严重四肢瘫脑瘫（CP）患者（19只腕关节）采用克氏针或钢板固定实现腕关节融合的临床和影像学结果。手术时患者的平均年龄为16.8±1.7岁（14 - 20岁）。14例患者的平均随访时间为5.9±3.1年（范围1 - 11年）。手术指征为严重的腕关节畸形，影响卫生护理。并发症较少，结果令人满意。术前和术后影像学角度存在统计学显著差异（侧位和前后位视图分别为37°，P = 0.001和24°，P = 0.04）。护理人员报告称，外观是手术最主要的原因（63%）。改善卫生护理是主要的预期益处。大多数（88%）对结果满意。我们建议对严重四肢瘫CP患者进行腕关节融合，以改善手腕、手部和手指的卫生护理、摆放位置及外观。
