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KMID : 0621520080130010001
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Journal of the Korean Society for Surgery of the Hand
2008 Volume.13 No. 1 p.1 ~ p.7
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Patient-based Functional and Cosmetic Outcome of Upper Extremity Surgery for Cerebral Palsy
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Bin Sung-Woo
Chung Moon-Sang
Chung Chin-Youb
Baek Goo-Hyun
Lee Young-Ho
Park Moon-Seok
Nah Young-Gon
Gong Hyun-Sik
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Abstract
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Purpose: Little is known on the outcome of upper extremity surgery for cerebral palsy from a patient or caregiver perspective. The purpose of this study was to evaluate patient-reported functional and cosmetic outcome of upper extremity surgery in patients with hemiplegic cerebral palsy.
Materials and Methods: Between January 2006 and March 2007, we performed upper extremity surgeries on 9 patients with hemiplegic cerebral palsy. Four were male and five were female, and the mean age at the operation was 22(range: 7~54) years. The number of procedures per patient averaged 8.7(range: 4~14) and all procedures were done simultaneously. An interviewer who had not been involved in the treatment retrospectively reviewed patient-reported House function scale(0~8), status of hygiene(0~4), ability to dress(0~4), subjective cosmesis(0~4), and overall satisfaction(0~4). The follow- up averaged 12.4(range 7~18) months.
Results: Patient-reported House scale improved from average 3.3 to 4.6(p<0.05), while physician-assessed House scale improved from 2.9 to 5.2(p<0.05). The difference of net improvement between the patient and the physician-based scale was significant (p<0.05). The mean status of hygiene improved from 3.2 to 4(p<0.05), the ability to dress from 3.3 to 4(p<0.05) and the subjective cosmesis from 2 to 3.8(p<0.05).
Conclusion: After upper extremity surgery, cerebral palsy patients reported less improvement in the House scale than the authors assessed in the short-term followup. Although not all patients were satisfied with the functional results, all expressed improvement in the cosmetic outcome. This information may help patient consulting before upper extremity surgery in patients with cerebral palsy.
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KEYWORD
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Upper extremity surgery, Cerebral palsy, Hemiplegia, Patient-based outcome
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