DOES COGNITIVE CAPACITY INTERFERE WITH THE OUTCOME OF OBERLIN TRANSFER?

ABSTRACT Objective: To determine the relationship between the functional outcome achieved following Oberlin transfer, the cognitive level of the patient, and the time elapsed between the trauma event and surgery. Methods: Eighteen patients with a traumatic injury to the brachial plexus (C5-C6 and C5-C7) were evaluated. Seventeen (94.4%) patients were males and one (5.6%) was female, with a mean age of 29.5 years (range 17-46 years). We evaluated the active range of motion, elbow flexion strength, and Disabilities of the Arm, Shoulder and Hand (DASH) and determined the correlation between the procedural outcome and the patient's cognitive level, as assessed by the Mini-Mental State Exam (MMSE). Results: We found statistically significant correlations between the MMSE scale and strength recovery (84.4%, p&lt;0.001), which was classified as excellent, and between the MMSE and British Medical Research Council (BMRC) scales (78.4%, p&gt;0.001), which classified cognitive level as good. Conclusions: We found a positive correlation between cognitive capacity and functional outcome of patients submitted to Oberlin surgery. The time elapsed between trauma and the surgical procedure showed an inversely proportional correlation with the strength of recovery. Level of Evidence II, Retrospective Study.摘要 研究目的：明确Oberlin神经转位术（Oberlin transfer）术后的功能预后、患者认知水平，以及创伤事件至手术的间隔时间三者之间的关联。 研究方法：本研究共纳入18例臂丛神经（brachial plexus）C5-C6及C5-C7创伤患者进行评估。其中男性17例（占比94.4%），女性1例（占比5.6%），患者平均年龄为29.5岁（年龄范围17~46岁）。本研究评估了患者的主动活动度、肘关节屈曲肌力，以及上肢、肩部和手部功能障碍（Disabilities of the Arm, Shoulder and Hand, DASH）量表评分，并通过简易精神状态检查表（Mini-Mental State Exam, MMSE）评估患者认知水平，进而分析手术预后与患者认知水平的相关性。 研究结果：本研究发现，MMSE量表评分与肌力恢复情况（分级为优良，占比84.4%，p<0.001）存在统计学显著相关性；此外，MMSE量表与英国医学研究理事会（British Medical Research Council, BMRC）量表（认知水平被评为良好的占比78.4%，p>0.001）亦存在相关性。 研究结论：本研究证实，接受Oberlin手术的患者其认知能力与术后功能预后呈正相关；创伤至手术的间隔时间与肌力恢复程度呈负相关。本研究证据级别为Ⅱ级，属于回顾性研究。