Effect of Radioulnar Derotational Osteotomy on Hand Function in Patients With Brachial Plexus Injury: A Case Series Study.

IF 1.5 3区医学 Q3 ORTHOPEDICS

Journal of Pediatric Orthopaedics Pub Date : 2025-10-01 Epub Date: 2025-07-14 DOI:10.1097/BPO.0000000000003039

Ramin Zargarbashi, Ali Nami Damirchi, Sina Esmaeili, Monir Najafi Pirasteh

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引用次数: 0

Abstract

Background: Childhood brachial plexus injury (BPI) is a severe nerve injury leading to significant functional impairments, including supination deformities that restrict hand function and complicate daily activities. This study aimed to evaluate the effect of radioulnar derotational osteotomy (RUDO) on hand function in children with BPI and supination deformity.

Methods: A case series of 16 BPI patients (mean age: 7.44 ± 1.26 y) undergoing RUDO at a tertiary care center from 2019 to 2023 was analyzed. Inclusion criteria encompassed supination deformity with a minimum 12-month follow-up and functional wrist motion. Hand function was assessed preoperatively and postoperatively using the Functional Grasp Scale (FGS) and Activities of Daily Living (ADL) scores. Statistical analysis was conducted to compare outcomes.

Results: RUDO significantly improved functional outcomes. The mean FGS score rose from 2.81 ± 4.17 preoperatively to 6.13 ± 2.99 postoperatively ( P < 0.001). Similarly, the mean ADL score increased from 1.50 ± 0.99 to 8.69 ± 1.65 ( P < 0.001). Subdomains of ADL, including domestic activities and physical self-maintenance, showed significant enhancements. No group-specific differences were observed in functional improvement, indicating consistent benefits across varying preoperative finger function statuses.

Conclusions: RUDO is a minimally invasive, effective procedure that significantly enhances hand function and daily living capabilities in children with BPI and supination deformity. This technique offers reliable functional improvements. Further longitudinal studies are needed to confirm sustained benefits.

Level of evidence: Level IV-case series.

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尺桡旋转截骨术对臂丛神经损伤患者手部功能的影响：一个病例系列研究。

背景：儿童臂丛神经损伤（BPI）是一种严重的神经损伤，可导致严重的功能损害，包括旋后畸形，限制了手功能并使日常活动复杂化。本研究旨在评估尺桡旋转截骨术（RUDO）对BPI和旋后畸形儿童手部功能的影响。方法：分析2019 - 2023年在某三级保健中心接受RUDO治疗的16例BPI患者（平均年龄：7.44±1.26 y）的病例系列。纳入标准包括至少随访12个月的旋后畸形和腕部功能运动。术前和术后采用功能掌握量表（FGS）和日常生活活动（ADL）评分评估了手功能。对结果进行统计学分析比较。结果：RUDO显著改善了功能预后。FGS评分由术前的2.81±4.17分上升至术后的6.13±2.99分（P < 0.001）。平均ADL评分由1.50±0.99上升至8.69±1.65 （P < 0.001）。ADL的子领域，包括家庭活动和身体自我维持，表现出显著的增强。在功能改善方面没有观察到组特异性差异，表明术前不同手指功能状态的益处是一致的。结论：RUDO是一种微创、有效的手术，可显著提高BPI和旋后畸形患儿的手部功能和日常生活能力。这种技术提供了可靠的功能改进。需要进一步的纵向研究来证实持续的益处。证据级别：iv级病例系列。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Pediatric Orthopaedics 医学-小儿科

CiteScore

3.30

自引率

17.60%

发文量

512

审稿时长

6 months

期刊介绍： Journal of Pediatric Orthopaedics is a leading journal that focuses specifically on traumatic injuries to give you hands-on on coverage of a fast-growing field. You''ll get articles that cover everything from the nature of injury to the effects of new drug therapies; everything from recommendations for more effective surgical approaches to the latest laboratory findings.