■Camptodactyly,拇指紧扣,和被风吹动的手是远端关节病(DA)的显着特征。目前的治疗干预措施往往产生次优的效果,易感患者复发和并发症。这项研究阐明了一种纠正方法,该方法涉及渐进式扩展支具来管理DA并评估其临床结果。
■在2015年至2023年之间,在32位DA患者中使用了渐进式延伸矫正器,平均随访4.8年。患者按年龄分为四组:0-1、1-3、3-7和7岁以上。根据掌指关节(MPJ)和近端指间关节(PIPJ)的总主动运动(TAM)评估了喜树皮的矫正,以及PIPJ的伸肌滞后。通过测量拇指至食指的掌骨角度(M1M2角度)和在第一个MPJ(M1P1角度)处的偏差程度来评估紧握的拇指矫正。使用PedsQL4.0测量儿童的生活质量,而使用FACE问卷测量父母的满意度。
■采用渐进式伸展支撑的早期干预可产生出色的矫正效果。0-1岁的婴儿和1-3岁的幼儿在矫正后的平均TAM得分分别为152°和126°;但是,3岁以上患者接受相同治疗后TAM显著下降.患有DA的婴儿和幼儿的平均伸肌滞后从46°改善到6°。M1M2角度从平均38°增加到65°,M1P1角度从平均43°减小到5°。治疗后,平均PedsQL评分分别为94.7分(家长报告)和89.3分(儿童报告).32位家长中,24表示非常满意,5表示适度的满意,3表示相当满意。
■早期,进步,持续使用伸展支具可显着改善关节活动度,并矫正了弯曲和紧握的拇指。这可能是解决DA患者手畸形的有效方法。
UNASSIGNED: Camptodactyly, clasped thumbs, and windblown hands are distinctive features of distal arthrogryposis (DA). Current therapeutic interventions often yield suboptimal effects, predisposing patients to relapses and complications. This study explicates a corrective approach involving a progressive extension brace for the management of DA and evaluates its clinical outcomes.
UNASSIGNED: Between 2015 and 2023, progressive extension braces were used in 32 DA patients, with an average follow-up of 4.8 years. Patients were stratified by age into four groups: 0-1, 1-3, 3-7, and above 7 years. The correction of
camptodactyly was assessed based on the total active movement (TAM) of metacarpophalangeal joints (MPJ) and proximal interphalangeal joints (PIPJ), as well as the extensor lag of PIPJ. Clasped thumb correction was evaluated by measuring the thumb-to-index finger metacarpal angle (M1M2 angle) and the degree of deviation at the first MPJ (M1P1 angle). The quality of life for the children was measured using PedsQL 4.0, while parental satisfaction was gauged using the FACE questionnaire.
UNASSIGNED: Earlier intervention with a progressive extension brace yielded superior corrective results. Infants aged 0-1 year and toddlers aged 1-3 years achieved average TAM scores of 152° and 126° after correction; however, patients older than 3 years experienced a significant decrease in TAM with the same treatment. Infants and toddlers with DA showed improvement in the average extensor lag from 46° to 6°. The M1M2 angle increased from an average of 38° to 65°, with the M1P1 angle decreasing from an average of 43° to 5°. After the treatment, average PedsQL scores of 94.7 (parent-reported) and 89.3 (child-reported) were achieved. Among the 32 parents, 24 expressed high satisfaction, 5 expressed moderate satisfaction, and 3 expressed fair satisfaction.
UNASSIGNED: The early, progressive, and consistent use of an extension brace significantly improved joint mobility and corrected
camptodactyly and clasped thumbs. It can be an effective approach to addressing hand deformities in patients with DA.