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Retrospective study of functional benefits and satisfaction in multisite upper-limb surgery in children with
Audrey Combey1, Rachel Bard-Pondarré1, Lionel Erhard2
1Centre des Massues - Croix-Rouge Française, 92 rue Edmond Locard, 69322 Lyon Cedex 5, France.
Insights
Individualized neuro-orthopedic surgery for children with unilateral cerebral palsy significantly improved upper-limb function and patient satisfaction. Further research is recommended to explore bimanual performance impacts.
Area of Science:
- Pediatric Orthopedics
- Neurorehabilitation
- Cerebral Palsy Research
Background:
- Unilateral cerebral palsy (UCP) significantly impacts upper-limb function.
- Multisite neuro-orthopedic surgery is a treatment option for UCP.
- Evaluating functional outcomes and patient satisfaction is crucial.
Purpose of the Study:
- To assess the functional impact of individualized multisite neuro-orthopedic upper-limb surgery in children with UCP.
- To evaluate patient satisfaction following this surgical intervention.
Main Methods:
- Retrospective study of 23 children with UCP (mean age 13.2 years).
- Interventions included botulinum toxin, splints, and functional training.
- Evaluated unilateral function (Melbourne Assessment, Box and Blocks test), bimanual performance (Assisting Hand Assessment), and goal achievement.
- Patient satisfaction assessed 6-14 months post-surgery.
Main Results:
- Significant improvement in Melbourne Assessment dexterity (11.7 points, p=0.003) and range of motion (10.6 points, p=0.005).
- High patient satisfaction reported in 81% of cases.
- Botulinum toxin, splints, and functional training were part of the care pathway.
Conclusions:
- Multisite neuro-orthopedic surgery within a global care pathway enhances unilateral upper-limb function and patient satisfaction in children with UCP.
- Further studies with larger, more homogeneous cohorts are needed to investigate the impact on bimanual performance.
Objectives:
To evaluate the functional impact of individualised multisite neuro-orthopedic upper-limb surgery in children with unilateral cerebral palsy, and to assess patient satisfaction.
Patients And Methods:
This retrospective study evaluated the impact of surgery on unilateral functional capacity on the Melbourne Assessment (MA2) and Box and Blocks test, on bimanual performance on the Assisting Hand Assessment, and on achievement of individualised goals. Satisfaction was assessed on a Likert scale between 6 and 14 months after surgery.
Results:
Twenty-three children were included (mean age, 13.2 ± 3 years). They underwent neuro-orthopedic surgery as part of their care pathway, with botulinum toxin, splints and functional training. After surgery, there was a significant 11.7-point improvement in the MA2 dexterity domain (p = 0.003) and 10.6 points in the MA2 range of motion domain (p = 0.005). Satisfaction was high in 81% of patients.
Conclusion:
Neuro-orthopedic upper-limb surgery included in a global care pathway in children with unilateral cerebral palsy improved unilateral upper-limb function and patient satisfaction. The present cohort should be expanded to further explore the impact of surgery on bimanual performance, focusing on more homogeneous functional levels and surgical procedures.
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