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前臂延长术后的上肢:患者与医生的观点

Upper Limb after Forearm Lengthening in Patients' and Physicians' Perspective.

机构信息

Uniwersytet Jagielloński, Colegium Medicum, Klinika Ortopedii i Rehabilitacji, Kraków, Polska / Jagiellonian University, Collegium Medicum, Department of Orthopaedics and Rehabilitation, Cracow, Poland.

出版信息

Ortop Traumatol Rehabil. 2020 Feb 29;22(1):7-16. doi: 10.5604/01.3001.0013.9778.

Abstract

BACKGROUND

The goal of this study was to perform a functional (subjective) and radiological evaluation of patients who had undergone forearm lengthening by distraction osteogenesis years before.

MATERIAL AND METHODS

Eleven patients with forearm shortening of various etiology were enrolled. They had undergone a total of 21 lengthening procedures. A retrospective analysis of radiological data was conducted and a subjective evaluation was accomplished by using a modified QuickDASH-9 questionnaire.

RESULTS

Average bone lengthening was 3.54cm, and mean lengthening index was 40.53day/cm. Eight pa-tients answered the questionnaire at a mean of 7.8yrs after the treatment. The mean questionnaire score was 9.75pts (of 36). Four patients rated the overall function of the affected limb as improved following distraction, while 3 patients were not able to see any improvement. One patient reported that the lengthening had impaired limb function. With regard to cosmetic aspects, 4 patients reported a worsening after the lengthening procedure while 3 patients reported improvement and 1 patient did not note any changes.

CONCLUSIONS

  1. Despite deformities and functional limitations, patients after forearm lengthening only occasionally suffered from moderate intensity pain. 2. The radiological outcomes were positive and the rate of complications was low. 3. The radiological outcomes did not match patient-declared functional and cosmetic results.
摘要

背景

本研究的目的是对多年前接受前臂延长术(骨牵引)的患者进行功能(主观)和影像学评估。

材料与方法

共纳入 11 例各种病因导致的前臂缩短患者,共进行了 21 次延长手术。对影像学数据进行回顾性分析,并采用改良的 QuickDASH-9 问卷进行主观评估。

结果

平均骨延长 3.54cm,平均延长指数为 40.53 天/cm。8 例患者在治疗后平均 7.8 年回答了问卷。平均问卷得分为 9.75 分(满分 36 分)。4 例患者认为牵引后患肢功能改善,3 例患者未观察到任何改善。1 例患者报告说延长术影响了肢体功能。在美容方面,4 例患者报告延长术后外观恶化,3 例患者报告改善,1 例患者未注意到任何变化。

结论

  1. 尽管存在畸形和功能限制,但前臂延长后的患者仅偶尔出现中度疼痛。2. 影像学结果为阳性,并发症发生率低。3. 影像学结果与患者报告的功能和美容结果不匹配。

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