From the Hospital for Special Surgery, New York, NY.
J Am Acad Orthop Surg Glob Res Rev. 2021 Aug 10;5(8):e21.00182. doi: 10.5435/JAAOSGlobal-D-21-00182.
The purpose of this study was to determine how Limb Deformity Modified Scoliosis Research Society (LD-SRS) scores differ between patients with different types and degrees of limb deformity compared with control subjects.
Patients who were >17 years and scheduled for reconstructive surgery for limb lengthening or angular deformity with internal and/or external fixation and healthy control subjects were prospectively enrolled. Patients completed the LD-SRS preoperatively. Mechanical axis deviation (MAD) and leg length discrepancy (LLD) were recorded preoperatively. Participants were stratified into five groups based on their diagnosis. ANOVA was used to test for associations between LD-SRS scores and diagnosis as well as mechanical axis deviation.
Patients with LLD, angular deformity, or combined LLD and angular deformity reported significantly worse scores than control subjects in LD-SRS Function/Activity, Pain, Self-Image/Appearance, and total score (P < 0.001 for all). Patients with short stature reported significantly worse LD-SRS Self-Image/Appearance (P < 0.001) and total score compared with control subjects (P = 0.015). There was a significant correlation between LLD and LD-SRS Self-Image/Appearance in the LLD and angular deformity group (r = -0.359, P = 0.043).
Although LD-SRS scores were worse in patients with limb deformity compared to controls, LD-SRS scores were not related to the degree of deformity in most patients, indicating that patient self-perception may be a construct unrelated to objective radiographic or clinical findings.
本研究的目的是确定与对照相比,患有不同类型和程度肢体畸形的患者的肢体畸形改良脊柱侧凸研究学会(LD-SRS)评分有何不同。
前瞻性纳入>17 岁并计划接受肢体延长或成角畸形内固定和/或外固定重建手术的患者及健康对照者。患者术前完成 LD-SRS 评分,记录术前机械轴偏差(MAD)和肢体长度差异(LLD)。根据诊断将参与者分为五组。采用 ANOVA 检验 LD-SRS 评分与诊断以及机械轴偏差之间的关系。
存在 LLD、成角畸形或 LLD 和成角畸形并存的患者的 LD-SRS 功能/活动、疼痛、自我形象/外观和总分评分显著差于对照组(所有 P < 0.001)。身材矮小的患者的 LD-SRS 自我形象/外观(P < 0.001)和总分评分显著差于对照组(P = 0.015)。在 LLD 和成角畸形组中,LLD 与 LD-SRS 自我形象/外观之间存在显著相关性(r = -0.359,P = 0.043)。
尽管与对照组相比,肢体畸形患者的 LD-SRS 评分较差,但大多数患者的 LD-SRS 评分与畸形程度无关,这表明患者的自我感知可能是一种与客观影像学或临床发现无关的结构。