Raposo-Amaral Cassio Eduardo, Denadai Rafael, do Monte Lameiro Thais Miguel, de Oliveira Yuri Moresco, Raposo-Amaral Cesar Augusto
Institute of Plastic and Craniofacial Surgery, SOBRAPAR Hospital, Campinas, São Paulo, Brazil.
Plast Reconstr Surg Glob Open. 2019 May 1;7(5):e2230. doi: 10.1097/GOX.0000000000002230. eCollection 2019 May.
The Michigan Hand Questionnaire is widely used to assess hand outcomes in congenital hand deformities. The purpose of the present study is to compare Apert syndrome hand outcomes according to Upton hand type and age stratification with age-matched unaffected controls.
The Brief Michigan Hand Questionnaire was administered to 39 Apert patients after completion of the digit separation surgical regimen, and 140 age-matched unaffected controls. Patients were divided into 3 groups according to age. In group 1 (from 4 months to 7 years of age), responses were provided by parents of Apert patients, and in group 2 (from 8 to 17 years of age), patients responded with assistance from their parents, and in group 3 (18 years of age or older), responses were provided by the patients themselves. Groups were substratified according to Upton hand type (type I, II, and III). Comparisons were made among groups, subgroups, and controls.
Comparisons of hand types for intragroups 1, 2, and 3, did not demonstrate any statistically significant differences ( > 0.05) between hand outcomes according to Upton hand type, regardless of patient age. Comparisons between Apert patients and their age-matched controls demonstrated statistically significant differences ( < 0.05), as the control group had higher outcome scores.
Similar hand outcomes scores were achieved by all Apert patients regardless of hand type. Following completion of the digit separation regimen, Apert patients presented hand outcome scores that were lower than those of the patients in the normative control group.
密歇根手功能问卷被广泛用于评估先天性手部畸形的手部功能结果。本研究的目的是根据厄普顿手型和年龄分层，将Apert综合征的手部功能结果与年龄匹配的未受影响的对照组进行比较。
在完成手指分离手术方案后，对39例Apert患者和140例年龄匹配的未受影响的对照组进行了简短的密歇根手功能问卷调查。患者根据年龄分为3组。在第1组（4个月至7岁），由Apert患者的父母提供回答；在第2组（8至17岁），患者在父母的协助下回答；在第3组（18岁及以上），由患者自己提供回答。各小组根据厄普顿手型（I型、II型和III型）进一步分层。对各小组、亚组和对照组进行了比较。
第1、2和3组内不同手型之间的比较显示，无论患者年龄如何，根据厄普顿手型的手部功能结果之间均无统计学显著差异（>0.05）。Apert患者与其年龄匹配的对照组之间的比较显示出统计学显著差异（<0.05），因为对照组的功能结果得分更高。
无论手型如何，所有Apert患者的手部功能结果得分相似。在完成手指分离方案后,Apert患者的手部功能结果得分低于正常对照组患者。
