Ido Yoshikazu, Uchiyama Shigeharu, Nakamura Koichi, Itsubo Toshiro, Hayashi Masanori, Hata Yukihiko, Imaeda Toshihiko, Kato Hiroyuki
Rehabilitation Center, Shinshu University Hospital, Matsumoto, Japan.
Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto, Japan.
Sci Rep. 2016 Jun 6;6:27497. doi: 10.1038/srep27497.
We investigated a recovery pattern in subjective and objective measures among 52 patients with cubital tunnel syndrome after anterior subcutaneous transposition of the ulnar nerve. Disabilities of the Arm, Shoulder and Hand (DASH) score (primary outcome), numbness score, grip and pinch strength, Semmes-Weinstein (SW) score, static 2-point discrimination (2PD) score, and motor conduction velocity (MCV) stage were examined preoperatively and 1, 3, 6, 12, and ≥24 months postoperatively. Statistical analyses were conducted to evaluate how each variable improved after surgery. A linear mixed-effects model was used for continuous variables (DASH score, numbness, grip and pinch strength), and a proportional odds model was used for categorical variables (SW and 2PD tests and MCV stages). DASH score significantly improved by 6 months. Significant recovery in numbness and SW test scores occurred at 1 month. Grip and pinch strength, 2PD test scores, and MCV stage improved by 3 months. DASH scores and numbness recovered regardless of age, sex, or disease severity. It was still unclear if both subjective and objective measures improved beyond 1-year postoperatively. These data are helpful for predicting postoperative recovery patterns and tend to be most important for patients prior to surgery.
我们对52例尺神经前皮下转位术后的肘管综合征患者的主观和客观指标恢复模式进行了研究。术前及术后1、3、6、12和≥24个月检查了手臂、肩部和手部功能障碍(DASH)评分(主要结局)、麻木评分、握力和捏力、Semmes-Weinstein(SW)评分、静态两点辨别觉(2PD)评分以及运动传导速度(MCV)分期。进行统计分析以评估术后各变量的改善情况。对于连续变量(DASH评分、麻木、握力和捏力)使用线性混合效应模型,对于分类变量(SW和2PD测试以及MCV分期)使用比例优势模型。DASH评分在术后6个月时显著改善。麻木和SW测试评分在术后1个月时出现显著恢复。握力和捏力、2PD测试评分以及MCV分期在术后3个月时得到改善。DASH评分和麻木恢复情况与年龄、性别或疾病严重程度无关。术后1年以上主观和客观指标是否均有改善仍不清楚。这些数据有助于预测术后恢复模式,并且对手术前的患者往往最为重要。