Implications of thumb position and trajectory in tetraplegia grip reconstruction - a cohort study.
Publisher DOI
PubMed ID
37393337
Abstract
STUDY DESIGN
This study represents a retrospective observational cohort study.
OBJECTIVES
The objective of this study was to investigate the impact of thumb position on postoperative patient-rated and functional outcomes in grip reconstruction surgery.
SETTING
All consecutive adult patients with tetraplegia undergoing grip reconstruction surgery at the Swiss Paraplegic Centre between 06/2008 and 11/2020 were assessed for eligibility.
METHODS
Standardized photo or film documentation was used for individually recreating and categorizing thumb position and trajectory during key pinch. Outcome measurements included key pinch strength, Canadian Occupational Performance Measure (COPM) and Grasp Release Test (GRT).
RESULTS
Fifty-six hands of 44 patients (mean age 42.2 years, range 18-70 years) with a mean follow-up of 14.8 months (range 6 months to 12 years) were included. There was a significant postoperative improvement of key pinch strength, COPM score and GRT. COPM improvement was more pronounced for hands with more palmar abducted trajectories of the thumb.
CONCLUSIONS
Regardless of reconstruction type, pinch strength, patient satisfaction and grasp and release abilities improved significantly after surgery. Thumb position and trajectory are strong determining factors for the selected outcome measurements.
This study represents a retrospective observational cohort study.
OBJECTIVES
The objective of this study was to investigate the impact of thumb position on postoperative patient-rated and functional outcomes in grip reconstruction surgery.
SETTING
All consecutive adult patients with tetraplegia undergoing grip reconstruction surgery at the Swiss Paraplegic Centre between 06/2008 and 11/2020 were assessed for eligibility.
METHODS
Standardized photo or film documentation was used for individually recreating and categorizing thumb position and trajectory during key pinch. Outcome measurements included key pinch strength, Canadian Occupational Performance Measure (COPM) and Grasp Release Test (GRT).
RESULTS
Fifty-six hands of 44 patients (mean age 42.2 years, range 18-70 years) with a mean follow-up of 14.8 months (range 6 months to 12 years) were included. There was a significant postoperative improvement of key pinch strength, COPM score and GRT. COPM improvement was more pronounced for hands with more palmar abducted trajectories of the thumb.
CONCLUSIONS
Regardless of reconstruction type, pinch strength, patient satisfaction and grasp and release abilities improved significantly after surgery. Thumb position and trajectory are strong determining factors for the selected outcome measurements.
Date Issued
2023-07-01
Publication Type
Article
Subject(s)
Language(s)
en
Author(s)
Schibli, Silvia | |
Koch-Borner, Sabrina | |
Fridén, Jan |
Journal
Spinal cord series and cases
Publisher
Springer Nature
ISSN
2058-6124
Access(Rights)
metadata.only