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· DOS Abstracts
Long-term effect of surgery for thumb in palm in
adolescent cerebral palsy patients.
Hans Tromborg, Alice Ørts
Hand Surgery, Dept of Ortopaedic Surgery, Odense University Hospital;
Department of Rehabilitation (Hand), Odense University Hospital
Background:
Cerebral palsy of the hand can be a seriously debilitating illness,
especially hand activities demanding the use of two hands can be affected. The
ability to open the hand to grip objects and bringing the fist finger into contact
with the second finger (pinch key grip) are cornerstones of hand function.
Purpose / Aim of Study:
To evaluate the long-term effect of thumb surgery
for thumb in palm spasticity in adolescent patients with cerebral palsy.
Materials and Methods:
Twenty six patients with cerebral palsy was surgically
reconstructed with flexor carpi ulnaris (FCU) transferal to the extensor carpi
radialis brevis (ECRB) and surgery to correct the thumb in palm deformity. Age
15(6) years (AVG (SD)). Hand opening was measured as the ability to grasp
a wooden cylinder with contact to the web space between the first and the
second finger. Two hand activities (THAc) were measured by awarding points
for the use of two hands in pre-defined and standardized two hand activities
(modified Sollerman hand test). Maximum possible points was 15. After sur-
gery, the patients were treated with immobilization in a cast for eight weeks. All
patients initially received highly specialized rehabilitation and afterwards guided
therapy.
Findings / Results:
Patients increased hand opening from 4.6 (1.5) cm (AVG
(SD)) preoperatively to 5.5 (1.3) cm (p<0.05) after half a year and increased
points of THAc from 9.2 (4.1) points preoperatively to 11.8 (4.0) points
(p<0.001) after half a year. Hand opening and THAc increased a little from
6 months to 18 months and therefore remained statistically significantly im-
proved.
Conclusions:
In carefully selected adolescent children with cerebral palsy hand
opening and two hand function can be improved by surgery and subsequent
hand therapy.
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