Ajiki Takashi, Murayama Akira, Hayashi Yukinori, Takeshita Katsushi
Department of Orthopedic Surgery, Jichi Medical University, Tochigi, Japan.
Department of Orthopedic Surgery, Ishibashi General Hospital, Tochigi, Japan.
J Hand Microsurg. 2021 Aug 25;15(3):181-187. doi: 10.1055/s-0041-1735347. eCollection 2023 Jun.
We have developed a handprint-based method for visualizing and quantifying the palmar contact of patients with Dupuytren's contracture. The purpose of this study was to examine whether the generated handprint was useful for assessing the severity of flexion contracture of the fingers and for evaluating the therapeutic effects of collagenase clostridium histolyticum (CCH) injection for Dupuytren's contracture. The handprint was created by applying medical-grade ethanol-containing hand sanitizer over the entire palmar surface of the affected hand and then pressing it on thermal paper for word processors. The reliability of the handprint was evaluated through test-retest of 10 healthy volunteers at an interval of 10 days, and the validity of the handprint was assessed using a flexion contracture model in which the little finger was fixed in an Alfence splint. In addition, we obtained handprints of the affected hand in 33 patients with unilateral Dupuytren's contracture both before CCH injection and at the final observation after injection to investigate the contact area of the hand (CAH) and the length of the hand (LH). The relationships between CAH, LH, total extension deficit angle (TEDA), and patient-reported outcome measures (Japanese Society for Surgery of the Hand Version of the Quick Disability of Arm, Shoulder, and Hand Questionnaire [Quick DASH-JSSH] and Hand20) were examined. The test-retest correlation coefficient was 0.9187 ( < 0.001) for CAH and 0.9052 ( < 0.001) for LH, indicating high reliability of the handprint. The ratios of CAH and LH decreased gradually as the contracture angle of the splinted finger increased. The handprint revealed a marked improvement of palmar contact after CCH injection for Dupuytren's contracture. Furthermore, the ratios of CAH and LH were strongly correlated with TEDA, Quick DASH-JSSH, and Hand20 before treatment. Our handprint-based assessment method was extremely useful for clinical evaluation of CCH treatment for Dupuytren's contracture. Therapeutic.
我们开发了一种基于手印的方法，用于可视化和量化掌腱膜挛缩症患者的手掌接触情况。本研究的目的是检验所生成的手印是否有助于评估手指屈曲挛缩的严重程度，以及评估溶组织梭状芽孢杆菌胶原酶（CCH）注射治疗掌腱膜挛缩症的疗效。
手印是通过将含医用级乙醇的洗手液涂抹在患手的整个手掌表面，然后按压在用于文字处理的热敏纸上制成的。通过对10名健康志愿者进行间隔10天的重测来评估手印的可靠性，并使用将小指固定在Alfence夹板中的屈曲挛缩模型来评估手印的有效性。此外，我们获取了33例单侧掌腱膜挛缩症患者在CCH注射前和注射后最终观察时患手的手印，以研究手部接触面积（CAH）和手长（LH）。研究了CAH、LH、总伸展缺损角度（TEDA）与患者报告的结局指标（日本手部外科学会版手臂、肩部和手部快速残疾问卷[Quick DASH-JSSH]和Hand20）之间的关系。
CAH的重测相关系数为0.9187（<0.001），LH的重测相关系数为0.9052（<0.001），表明手印具有较高的可靠性。随着夹板固定手指的挛缩角度增加，CAH和LH的比例逐渐降低。手印显示CCH注射治疗掌腱膜挛缩症后手掌接触有明显改善。此外，治疗前CAH和LH的比例与TEDA、Quick DASH-JSSH和Hand20密切相关。
我们基于手印的评估方法对于掌腱膜挛缩症CCH治疗的临床评估极为有用。
治疗性。
