Department of Plastic, Reconstructive and Hand Surgery, Erasmus MC, Rotterdam, the Netherlands; Hand and Arm Center, Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, MA.
Department of Plastic, Reconstructive and Hand Surgery, Erasmus MC, Rotterdam, the Netherlands.
J Hand Surg Am. 2023 Aug;48(8):780-787. doi: 10.1016/j.jhsa.2023.05.003. Epub 2023 Jun 9.
The purpose of this study was to report prospectively collected patient-reported outcomes of patients who underwent open thumb ulnar collateral ligament (UCL) repair and to find risk factors associated with poor patient-reported outcomes.
Patients undergoing open surgical repair for a complete thumb UCL rupture were included between December 2011 and February 2021. Michigan Hand Outcomes Questionnaire (MHQ) total scores at baseline were compared to MHQ total scores at three and 12 months after surgery. Associations between the 12-month MHQ total score and several variables (i.e., sex, injury to surgery time, K-wire immobilization) were analyzed.
Seventy-six patients were included. From baseline to three and 12 months after surgery, patients improved significantly with a mean MHQ total score of 65 (standard deviation [SD] 15) to 78 (SD 14) and 87 (SD 12), respectively. We did not find any differences in outcomes between patients who underwent surgery in the acute (<3 weeks) setting compared to a delayed setting (<6 months).
We found that patient-reported outcomes improve significantly at three and 12 months after open surgical repair of the thumb UCL compared to baseline. We did not find an association between injury to surgery time and lower MHQ total scores. This suggests that acute repair for full-thickness UCL tears might not always be necessary.
TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic II.
本研究旨在报告接受开放性拇指尺侧副韧带(UCL)修复术患者的前瞻性患者报告结局,并找出与患者报告结局不佳相关的风险因素。
纳入 2011 年 12 月至 2021 年 2 月期间接受开放性手术修复完全拇指 UCL 断裂的患者。将基线时的密歇根手功能问卷(MHQ)总分与术后 3 个月和 12 个月时的 MHQ 总分进行比较。分析 12 个月时 MHQ 总分与几个变量(即性别、受伤至手术时间、克氏针固定)之间的相关性。
共纳入 76 例患者。从基线到术后 3 个月和 12 个月,患者的 MHQ 总分分别从 65(标准差 [SD] 15)显著改善至 78(SD 14)和 87(SD 12)。我们未发现手术时间急性(<3 周)与延迟(<6 个月)组之间的结局存在差异。
我们发现,与基线相比,开放性拇指 UCL 修复术后 3 个月和 12 个月时患者的报告结局显著改善。我们未发现受伤至手术时间与较低的 MHQ 总分之间存在关联。这表明对于全层 UCL 撕裂,急性修复不一定总是必要的。
研究类型/证据水平:治疗性 II 级。