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<0.001), which was classified as excellent, and between the MMSE and British Medical Research Council (BMRC) scales (78.4%, p>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 目的：明确奥伯林转位术（Oberlin transfer）后获得的功能预后、患者认知水平，以及创伤事件至手术的间隔时长三者之间的关联。 方法：本研究纳入18例臂丛神经（brachial plexus）C5-C6及C5-C7节段创伤患者并进行评估。其中17例（94.4%）为男性，1例（5.6%）为女性，患者平均年龄29.5岁，年龄区间为17~46岁。我们对受试者的主动活动度、肘关节屈曲肌力，以及上肢、肩部和手部功能障碍量表（Disabilities of the Arm, Shoulder and Hand, DASH）进行评估，并通过简易精神状态检查表（Mini-Mental State Exam, MMSE）评定患者认知水平，进而分析手术预后与患者认知水平之间的相关性。 结果：研究发现，简易精神状态检查表评分与肌力恢复情况（优良率84.4%，p<0.001）之间存在统计学意义显著的相关性；此外，简易精神状态检查表评分与英国医学研究理事会（British Medical Research Council, BMRC）认知分级量表（优良率78.4%，p>0.001）亦存在相关性。 结论：本研究证实，接受奥伯林手术患者的认知能力与功能预后呈正相关；创伤至手术的间隔时长与肌力恢复程度呈反比相关。本研究为II级证据等级的回顾性研究。