Redefining the Inclusion Criteria for Successful Steindler Flexorplasty Based on the Outcomes of a Case Series in Eight Patients.

IF 1.1 Q4 CLINICAL NEUROLOGY
Journal of Brachial Plexus and Peripheral Nerve Injury Pub Date : 2023-10-11 eCollection Date: 2023-01-01 DOI:10.1055/s-0043-1767672
Alexander A Gatskiy, Ihor B Tretyak, Jörg Bahm, Vitaliy I Tsymbaliuk, Yaroslav V Tsymbaliuk
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Abstract

Background (rationale)  Steindler flexorplasty (SF) is aimed at restoring independent elbow flexion in the late stages of dysfunction of the primary elbow flexors. Selection criteria for successful SF have been defined. Objectives  The purpose of this study was to redefine the inclusion criteria for successful SF based on functional outcomes. Methods  Eight patients received SF after an average of 50.8 months after injury or dysfunction. Three patients (37.5%) met all five Al-Qattan inclusion criteria (AQIC), and another five patients (62.5%) met four or less AQIC. Patients were followed up for at least 9 months, and the maximum range of active elbow flexion (REF) was measured. Functional results of SF were assessed using the Al-Qattan scale (in accordance with Al-Qattan's scale). Results  The mean maximum REF was 100 degrees (70 to 140 degrees). Five patients reached REF greater than 100 degrees. One patient had a poor outcome, two patients (25%) had a fair outcome, three patients (37.5%) had a good outcome, and two patients (25%) had an excellent outcome of SF on the Al-Qattan scale. The impact of each AQIC on functional outcome has been critically reviewed from a biomechanical point of view. Conclusions  The sufficient number of inclusion criteria required for successful SF can be reduced from five (according to AQIC) to two; Normal or near-normal function (M4 or greater on the MRC scale) of the muscles of the flexor-pronator mass should be considered an obligatory inclusion criterion, while primary wrist extensors may be considered an optional inclusion criterion.

Abstract Image

Abstract Image

基于8例患者的一系列病例结果,重新定义成功的斯坦德勒屈肌成形术的纳入标准。
背景(基本原理) 斯坦德勒屈肌成形术(SF)旨在恢复原发性屈肌功能障碍晚期的独立屈肘功能。已经确定了成功SF的选择标准。目标 本研究的目的是根据功能结果重新定义成功SF的纳入标准。方法 8名患者在受伤或功能障碍后平均50.8个月接受SF治疗。三名患者(37.5%)符合所有五项Al-Qattan纳入标准(AQIC),另有五名患者(62.5%)符合四项或更少的AQIC。对患者进行了至少9个月的随访,并测量了活动肘关节屈曲(REF)的最大范围。使用Al-Qattan量表(根据Al-Qattan's量表)评估SF的功能结果。后果 平均最大REF为100 度(70至140 度)。5名患者的REF大于100 度。在Al-Qattan量表上,一名患者的结果较差,两名患者(25%)的结果尚可,三名患者(37.5%)的结果良好,两名(25%)患者的SF结果良好。从生物力学的角度对每个AQIC对功能结果的影响进行了批判性的回顾。结论 成功SF所需的足够数量的纳入标准可以从五个(根据AQIC)减少到两个;屈肌旋前肌块肌肉的正常或接近正常功能(MRC量表上的M4或更大)应被视为强制性纳入标准,而初级腕伸肌可被视为可选纳入标准。
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来源期刊
CiteScore
1.70
自引率
14.30%
发文量
6
审稿时长
12 weeks
期刊介绍: JBPPNI is an open access, peer-reviewed online journal that will encompass all aspects of basic and clinical research findings, in the area of brachial plexus and peripheral nerve injury. Injury in this context refers to congenital, inflammatory, traumatic, degenerative and neoplastic processes, including neurofibromatosis. Papers on diagnostic and imaging aspects of the peripheral nervous system are welcomed as well. The peripheral nervous system is unique in its complexity and scope of influence. There are areas of interest in the anatomy, physiology, metabolism, phylogeny, and limb growth tropism of peripheral nerves.
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