幼儿期拇指再造术后的长期功能结局。
Long term functional outcomes after early childhood pollicization.
作者信息
Lightdale-Miric Nina, Mueske Nicole M, Lawrence Emily L, Loiselle Jennifer, Berggren Jamie, Dayanidhi Sudarshan, Stevanovic Milan, Valero-Cuevas Francisco J, Wren Tishya A L
机构信息
Children's Orthopaedic Center, Children's Hospital Los Angeles, Los Angeles, CA, USA; Orthopaedic Surgery Department, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
Children's Orthopaedic Center, Children's Hospital Los Angeles, Los Angeles, CA, USA.
出版信息
J Hand Ther. 2015 Apr-Jun;28(2):158-65; quiz 166. doi: 10.1016/j.jht.2014.11.003. Epub 2014 Dec 4.
STUDY DESIGN
Retrospective Cohort
INTRODUCTION
Important outcomes of polliciation to treat thumb hypoplasia/aplasia include strength, function, dexterity, and quality of life.
PURPOSE OF THE STUDY
To evaluate outcomes and examine predictors of outcome after early childhood pollicization.
METHODS
8 children (10 hands) were evaluated 3-15 years after surgery. Physical examination, questionnaires, grip and pinch strength, Box and Blocks, 9-hole pegboard, and strength-dexterity (S-D) tests were performed.
RESULTS
Pollicized hands had poor strength and performance on functional tests. Six of 10 pollicized hands had normal dexterity scores but less stability in maintaining a steady-state force. Predictors of poorer outcomes included older age at surgery, reduced metacarpophalangeal and interphalangeal range of motion, and radial absence.
DISCUSSION
Pollicization resulted in poor strength and overall function, but normal dexterity was often achieved using altered control strategies.
CONCLUSIONS
Most children should obtain adequate dexterity despite weakness after pollicization except older or severely involved children.
LEVEL OF EVIDENCE
IV.
研究设计
回顾性队列研究
引言
拇指发育不全/发育不良的拇指再造术的重要结果包括力量、功能、灵活性和生活质量。
研究目的
评估幼儿期拇指再造术后的结果并检查结果的预测因素。
方法
对8名儿童（10只手）在术后3至15年进行评估。进行了体格检查、问卷调查、握力和捏力测试、方块搭积木测试、九孔插板测试以及力量-灵活性（S-D）测试。
结果
再造拇指的力量较差，功能测试表现不佳。10只再造拇指中有6只灵活性评分正常，但在保持稳定力量方面稳定性较差。结果较差的预测因素包括手术时年龄较大、掌指关节和指间关节活动范围减小以及桡侧缺失。
讨论
拇指再造术导致力量和整体功能较差，但通过改变控制策略通常可实现正常的灵活性。
结论
除年龄较大或受累严重的儿童外，大多数儿童在拇指再造术后尽管力量较弱，但仍应能获得足够的灵活性。
证据级别
四级
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