Ferry N, Devilliers H, Pauchot J, Obert L, Tropet Y
Service de chirurgie orthopédie, traumatologique, plastique et réadaptation fonctionnelle, hôpital Jean-Minjoz, boulevard Fleming, 25030 Besancon cedex, France.
Chir Main. 2012 Oct;31(5):227-33. doi: 10.1016/j.main.2012.08.004. Epub 2012 Sep 24.
The authors suggest standardized questionnaires of quality of life to perform a long term evaluation of patients who underwent a replantation of the proximal upper limb.
This retrospective study is about patients who underwent a replantation of the proximal upper limb between 1979 and 2011. The functional assessment was conducted using several tools including the 400 points test, the sensory tests, the Disabilities of the Arm, Shoulder and Hand questionnaire and the CHEN's classification. Some questionnaires, like the Medical Outcome Study Short Form-36 dealt with the physical and the psychological sides of the quality of life. Other questionnaires were more specific, like the Body Image Scale.
Sixteen patients were included. The survival rate of the replanted limb was 75%. The mean follow-up was 12.7 years. We noted 20% good results with a mean DASH score to 24.5%. The quality of life was similar to the general population in most of 50% of cases. Some patients had depressive symptoms or body image troubles.
In our eyes, the evaluation of quality of life seems essential for these patients. Survival rates, functional results, follow-up, professional activity, gender and body image troubles influence the quality of life. Besides, the physical side and the psychological side must change together to affect the overall results of the quality of life.
作者建议使用标准化的生活质量问卷，对接受上肢近端再植手术的患者进行长期评估。
这项回顾性研究针对的是1979年至2011年间接受上肢近端再植手术的患者。使用多种工具进行功能评估，包括400分测试、感觉测试、手臂、肩部和手部功能障碍问卷以及陈氏分类法。一些问卷，如医学结局研究简表-36，涉及生活质量的身体和心理方面。其他问卷则更具针对性，如身体形象量表。
纳入16例患者。再植肢体的存活率为75%。平均随访时间为12.7年。我们注意到20%的患者效果良好，平均DASH评分为24.5%。在50%的大多数病例中，生活质量与普通人群相似。一些患者有抑郁症状或身体形象问题。
在我们看来，对这些患者进行生活质量评估似乎至关重要。存活率、功能结果、随访、职业活动、性别和身体形象问题会影响生活质量。此外，身体方面和心理方面必须共同改变，才能影响生活质量的整体结果。
