A Novel Method to Study Hip Growth and Development in Children with Cerebral Palsy.

IF 2 4区医学 Q2 PEDIATRICS

Children-Basel Pub Date : 2025-03-15 DOI:10.3390/children12030367

Luiz Carlos Almeida da Silva, Yusuke Hori, Burak Kaymaz, Jason J Howard, Arianna Trionfo, Michael Wade Shrader, Freeman Miller

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引用次数: 0

Abstract

Background: Knowledge of the relative contributions to different growth areas in the proximal femur and acetabulum is limited due to the complex anatomy and lack of growth markers in children. There is increasing interest in using guided growth to improve hip joint stability and decrease dysplasia in children with neurological disability. Some children with cerebral palsy (CP) are treated with bisphosphonates for bone insufficiency, which leaves a dense growth arrest band in the bone at the time of treatment. The aim of this study was to develop a novel approach to understand the growth and maturation impact on hip development in children with CP using this growth arrest band.

Methods: Pelvic radiographs of children with CP Gross Motor Function Classification System (GMFCS) level IV/V treated with bisphosphonate were analyzed. We measured neck-shaft angle (NSA), head-shaft angle (HSA), and migration percentage (MP) based on pamidronate bands (PamMP), NSA based on pamidronate bands (PamNSA), and HSA based on pamidronate bands (PamHSA). These measurements were compared using t-test.

Results: Seven children (two GMFCS IV and five GMFCS V) were included. The mean age of the radiographic assessment was 11.4 ± 1.3 (range, 8.6-12.5) years, mean MP 22 ± 7% (range, 13-39%), PamMP 33 ± 7% (range, 18-46%), NSA 151 ± 7° (range, 140-161°), PamNSA 153 ± 4° (range, 142-163°), HSA 164 ± 12° (range, 142-175°), and PamHSA 169 ± 8° (range, 154-175°). MP decreased by 10.5% compared with PamMP (p < 0.001). NSA compared with PamNSA (p = 0.117) and HSA compared with PamHSA (p = 0.325) were not statistically different.

Conclusions: This novel assessment method demonstrates that ossification of the lateral acetabulum and femoral head in children with CP GMFCS IV/V from age 8 to 12 years undergoes a mean decrease of 10% MP. A decrease of 10% MP after proximal femoral-guided growth has been reported as a positive outcome. However, based on the current measurements, this may be due to normal development. HSA and NSA remained unchanged.

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来源期刊

Children-Basel PEDIATRICS-

CiteScore

2.70

自引率

16.70%

发文量

1735

审稿时长

6 weeks

期刊介绍： Children is an international, open access journal dedicated to a streamlined, yet scientifically rigorous, dissemination of peer-reviewed science related to childhood health and disease in developed and developing countries. The publication focuses on sharing clinical, epidemiological and translational science relevant to children’s health. Moreover, the primary goals of the publication are to highlight under‑represented pediatric disciplines, to emphasize interdisciplinary research and to disseminate advances in knowledge in global child health. In addition to original research, the journal publishes expert editorials and commentaries, clinical case reports, and insightful communications reflecting the latest developments in pediatric medicine. By publishing meritorious articles as soon as the editorial review process is completed, rather than at predefined intervals, Children also permits rapid open access sharing of new information, allowing us to reach the broadest audience in the most expedient fashion.