Feldkamp M, Güth V
Z Orthop Ihre Grenzgeb. 1980 Apr;118(2):256-64. doi: 10.1055/s-2008-1053503.
During the last 15 years surgical interventions on the hands of 47 patients with cerebral palsy were performed. Most suffered from hemiplegia. Electromyographic analysis of arm- hand function showed 1. Decrease in maximal activity 2. Impulse irradiation preferably to flexor muscles 3. Associated activation of the affected contralateral limb 4. Identical patterns of activity in flexion or extension intentions 5. Occasionally reflex activity surmounts voluntary activity 6. Tendency towards tonic activation. By questionnaires the patients were asked to report their own impressions on the results of surgery as to function and appearance of the operated limb. In 30 replies 22 patients reported good results in appearance as well as in function and felt the procedure recommendable. Another 7 patients rated the result as fair, with partial improvement of appearance, without functional deterioration. The only patient who felt his condition worse suffered from epileptic disorder and related increase of spasticity with deterioration of gait to hand surgery, which, however, was without realistic grounds. It is concluded that corrective surgery in the hands of cerebral palsied patients may be fairly rewarding.
在过去15年中，对47例脑瘫患者的手部进行了外科手术干预。大多数患者患有偏瘫。对手臂-手部功能的肌电图分析显示：1. 最大活动度降低；2. 冲动优先向屈肌放射；3. 患侧对侧肢体的联合激活；4. 屈伸意图时相同的活动模式；5. 偶尔反射活动超过自主活动；6. 有强直激活的倾向。通过问卷调查，要求患者报告他们对手术结果的个人感受，包括手术肢体的功能和外观。在30份回复中，22名患者报告手术在外观和功能方面都取得了良好效果，并认为该手术值得推荐。另外7名患者认为结果尚可，外观有部分改善，功能没有恶化。唯一感觉自己病情加重的患者患有癫痫症，且因手部手术导致痉挛增加，步态恶化，但这并无实际依据。结论是，对脑瘫患者手部进行矫正手术可能会有相当不错的效果。
