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Effect of hemiplegia on skeletal maturation
C D Roberts1, L Vogtle, R D Stevenson
1Department of Pediatrics, University of Virginia School of Medicine, Charlottesville.
The Journal of Pediatrics
|November 1, 1994
Summary
Children with cerebral palsy (CP) experience delayed skeletal maturation on their affected side, independent of malnutrition. This brain injury effect may contribute to poor growth in pediatric CP patients.
Area of Science:
- Pediatric Orthopedics
- Neurology
- Developmental Biology
Background:
- Children with cerebral palsy (CP) often exhibit poor growth and delayed skeletal maturation.
- The precise cause, whether brain injury or malnutrition, remains unclear.
Purpose of the Study:
- To investigate the impact of hemiplegic cerebral palsy on skeletal maturation and growth.
- To use the unaffected limb as an internal control for each subject.
Main Methods:
- Bilateral hand-wrist radiographs were acquired from 19 children with spastic hemiplegia.
- Skeletal maturation was assessed using the blinded Fels method.
- Comparison of skeletal age between the affected and unaffected sides.
Main Results:
- All 19 subjects showed delayed skeletal maturation on the affected (hemiplegic) side compared to the unaffected (control) side.
- The average delay in skeletal age was 7.3 months (p < 0.001).
- Delayed maturation correlated with patient age and upper extremity function.
Conclusions:
- Brain injury in hemiplegic cerebral palsy directly causes delayed skeletal maturation.
- This delay is independent of nutritional status.
- The findings suggest a potential mechanism for poor growth observed in some children with cerebral palsy.