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先天性横肢缺失的治疗方法:来自日本全国性流行病学调查的数据分析。

Treatment approaches for congenital transverse limb deficiency: Data analysis from an epidemiological national survey in Japan.

机构信息

Department of Rehabilitation Medicine, The University of Tokyo Hospital, Tokyo, Japan; Department of Rehabilitation Medicine, Shizuoka Children's Hospital, Shizuoka, Japan.

Department of Rehabilitation Medicine, The University of Tokyo Hospital, Tokyo, Japan.

出版信息

J Orthop Sci. 2021 Jul;26(4):650-654. doi: 10.1016/j.jos.2020.05.008. Epub 2020 Jun 26.

Abstract

BACKGROUND

Congenital limb deficiency is a rare anomaly that impairs limb function. Transverse deficiency accounts for approximately half of congenital limb deficiency cases. In Japan, there have been no detailed data of clinical features, especially treatment approaches, of this disorder. The present study aimed to investigate the status of treatment approaches of congenital transverse limb deficiency in Japan.

METHODS

From the national epidemiological survey of congenital limb deficiency undertaken in Japan in 2016, all the data of 200 patients with congenital transverse limb deficiencies were extracted. These data were analysed to reveal the treatment approaches of congenital transverse limb deficiency and its basic clinical features.

RESULTS

Surgical treatments and prosthetic or orthotic intervention had been implemented or planned for about one-quarter of patients, respectively. In the upper limb deficiencies, prosthetic or orthotic intervention was likely chosen in cases of deficiency at the metacarpal or proximal to metacarpal level. Surgical treatment was chosen only in cases of deficiency at the carpal or distal to carpal level. Although the number of patients with transverse lower limb deficiencies was small, prosthetic or orthotic intervention was likely chosen in proximal deficiencies, and surgical treatment was likely chosen in distal deficiencies.

CONCLUSIONS

Herein, we revealed the status of treatment approaches for congenital transverse limb deficiency in Japan. Approximately half of the patients had no history of-and no plans for-surgical, prosthetic, or orthotic interventions. Further treatment advances may enable patients with congenital limb deficiencies to increase their participation in daily activities.

STUDY DESIGN

Cross-sectional survey.

摘要

背景

先天性肢体缺失是一种罕见的异常,会影响肢体功能。横向缺失约占先天性肢体缺失病例的一半。在日本,尚无该疾病详细的临床特征数据,特别是治疗方法的数据。本研究旨在调查日本先天性横向肢体缺失的治疗方法现状。

方法

从日本 2016 年开展的全国先天性肢体缺失流行病学调查中,提取了 200 名先天性横向肢体缺失患者的所有数据。对这些数据进行分析,以揭示先天性横向肢体缺失的治疗方法及其基本临床特征。

结果

分别约有四分之一的患者接受了手术治疗和假肢或矫形器干预。在上肢缺失中,在掌骨或掌骨近端水平缺失的情况下,可能选择假肢或矫形器干预;仅在手或腕骨远端水平缺失的情况下选择手术治疗。虽然下肢横向缺失的患者数量较少,但在近端缺失的情况下可能选择假肢或矫形器干预,在远端缺失的情况下可能选择手术治疗。

结论

本研究揭示了日本先天性横向肢体缺失的治疗方法现状。约有一半的患者没有接受过手术、假肢或矫形器干预的历史,也没有相关计划。进一步的治疗进展可能使先天性肢体缺失的患者能够更多地参与日常活动。

研究设计

横断面调查。

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