Patient-based Functional and Cosmetic Outcome of Upper Extremity Surgery for Cerebral Palsy

Journal of the Korean Society for Surgery of the Hand 2008;13(1):1-7.
Published online March 1, 2008.

Sung Woo Bin, Moon Sang Chung, Chin Youb Chung, Goo Hyun Baek, Young Ho Lee, Moon Seok Park, Young Gon Nah, Hyun Sik Gong

뇌성마비 상지의 수술적 치료에서 환자가 평가한 기능적 및 미용적 결과

빈성우, 정문상, 정진엽, 백구현, 이영호, 박문석, 나영곤, 공현식

Abstract

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.