Roth J H, O'Grady S E, Richards R S, Porte A M
Hand and Upper Limb Centre, St. Joseph's Hospital, London, Ontario, Canada.
J Hand Surg Br. 1993 Jun;18(3):299-303. doi: 10.1016/0266-7681(93)90045-h.
Children with spastic hemiplegia often present with upper limb muscle imbalance. The purpose of this paper was to determine whether reconstructive surgery improved their functional ability. 17 children under the age of 16 years with spastic hemiplegia underwent reconstruction that included tendon transfers, tendon lengthenings and thumb metacarpophalangeal fusion. They were assessed pre-operatively and at an average follow-up period of 2.6 years. Children's abilities were classified according to House's functional rating scale. Tendon transfers improved functional grading by two grades, from good passive assist to fair active assist. Improvement in the arc of wrist motion and forearm rotation was also seen. Parental satisfaction was high. Reconstructive surgery improved the functional abilities in this group of children with spastic hemiplegia.
痉挛性偏瘫儿童常出现上肢肌肉失衡。本文旨在确定重建手术是否能改善他们的功能能力。17名16岁以下的痉挛性偏瘫儿童接受了包括肌腱转移、肌腱延长和拇指掌指关节融合在内的重建手术。对他们进行了术前评估，并在平均2.6年的随访期进行了评估。根据豪斯功能评定量表对儿童的能力进行分类。肌腱转移使功能分级提高了两级，从良好的被动辅助提高到中等的主动辅助。腕关节活动弧度和前臂旋转也有改善。家长满意度较高。重建手术改善了这组痉挛性偏瘫儿童的功能能力。
