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同侧乳房切除术和背阔肌肌皮瓣重建术后肩部功能并发症的发生率。

Incidence of shoulder functional morbidity following ipsilateral mastectomy and latissimus dorsi flap reconstruction.

作者信息

Umar Muhammad, Jahangir Noman, Hughes Michael, Malik Qasim, Kokan Jalal, Waseem M

机构信息

Macclesfield District General Hospital, Macclesfield, UK.

Wythenshaw Hospital, Manchester, UK.

出版信息

Acta Orthop Traumatol Turc. 2019 Nov;53(6):448-451. doi: 10.1016/j.aott.2019.08.021. Epub 2019 Sep 24.

Abstract

INTRODUCTION

The aim of this study was to investigate the incidence of shoulder morbidity in our cohort of patients with latissimus dorsi flap reconstruction after mastectomy.

METHODS

This is a retrospective study of prospectively collected data of 72 patients using validate Oxford shoulder score for function and quickDASH score for disability. Scores were collected preoperatively and at time of final review or study. We also reviewed patient records for patients who had a formal diagnosis of shoulder pathology. Results were analysed with student t-test.

RESULTS

Analysis of scores showed a statistically significant worsening of both oxford shoulder score (p < 0.005) and quickDASH score (p < 0.005), when pre and post-operative scores were compared. Seven patients had a formal diagnosis of shoulder pathology, and all of them recovered well. There was no significant difference in oxford shoulder score or quickDASH scores between patients with or without shoulder pathology. About 40% patients had some functional loss or disability at 4 years after the surgery.

CONCLUSION

Our study shows a high incidence of significant shoulder functional morbidity following latissimus dorsi flap reconstruction but number of patients requiring specific treatment is low.

LEVEL OF EVIDENCE

Level IV, therapeutic study.

摘要

引言

本研究旨在调查我们队列中乳房切除术后背阔肌肌皮瓣重建患者的肩部疾病发生率。

方法

这是一项回顾性研究,对72例患者的前瞻性收集数据进行分析,使用经过验证的牛津肩部功能评分和快速DASH残疾评分。术前以及最终复查或研究时收集评分。我们还查阅了有正式肩部疾病诊断的患者记录。结果采用学生t检验进行分析。

结果

对评分的分析显示,比较术前和术后评分时,牛津肩部评分(p < 0.005)和快速DASH评分(p < 0.005)均有统计学意义的恶化。7例患者有正式的肩部疾病诊断,且所有患者恢复良好。有或无肩部疾病的患者在牛津肩部评分或快速DASH评分上无显著差异。约40%的患者在术后4年有一些功能丧失或残疾。

结论

我们的研究表明,背阔肌肌皮瓣重建术后肩部功能严重发病的发生率较高,但需要特殊治疗的患者数量较少。

证据水平

IV级,治疗性研究。

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