Turner A
J Bone Joint Surg Br. 1985 Mar;67(2):268-72. doi: 10.1302/0301-620X.67B2.3980539.
Hand function in 33 patients with myelomeningocele, aged from 4 to 17 years, was investigated by clinical examination and formal tests of co-ordination and dexterity. The average score for hand function was 59% of normal and only two children had clinically normal upper limbs. Twenty-eight patients (85%) had cerebellar ataxia, either alone or combined with other abnormal signs, most commonly upper motor neuron lesions. Hand function was significantly better in children of 11 years and older, in children under 11 with milder degrees of hydrocephalus, and in the younger children who were right-handed. Function was not shown to be better in those with lesions lower in the spine, nor in those with stable spines as has been previously reported. When co-ordination of the upper limb, manual dexterity and simultaneous movements of both arms were examined separately, these three were affected equally. Some abnormalities of hand function could be overcome by encouraging affected children to sit up and to practise skillful use of their hands as early in life as possible.
对33例年龄在4至17岁的脊髓脊膜膨出患者的手部功能进行了研究，采用临床检查以及协调性和灵活性的正式测试。手部功能的平均得分是正常水平的59%，只有两名儿童的上肢在临床上是正常的。28名患者（85%）患有小脑共济失调，单独出现或与其他异常体征合并出现，最常见的是上运动神经元病变。11岁及以上儿童、11岁以下脑积水程度较轻的儿童以及年幼的右利手儿童的手部功能明显更好。手部功能在脊柱病变位置较低的患者中并未表现出更好，也不像之前报道的那样在脊柱稳定的患者中更好。当分别检查上肢协调性、手部灵活性和双臂同时运动时，这三个方面受到的影响是相同的。鼓励受影响的儿童尽早坐起来并练习熟练使用双手，可以克服一些手部功能异常。
