Deformities of Spine and Lower Extremities in Teenagers with Cerebral Palsy

ABSTRACT

OBJECTIVE: To investigate the state of musculoskeletal deformities in spine and lower extremities in teenagers with cerebral palsy. METHOD: 79 teenagers with cerebral palsy attending special schools were examined for deformities of the spine and the lower extremities with physical examinations and radiographic studies. RESULTS: The number of cases with scoliosis was 47 (59.5%) and the mean of Cobb's angle was 21.7 degrees. There were 42 joints (26.6%) of hip subluxation and 10 joints (6.3%) of hip dislocation out of 158 hip joints. The mean of migration percentage was 53.6%. 30 participants (38.0%) had pelvic obliquity. The coxa valga appeared in 147 hip joints (93.0%), with the mean of femur neck-shaft angle was 156.0 degrees. It had a casual link with migration percentage (p<0.001). 131 knee joints (82.9%) had the increased popliteal angle and 113 knees (71.5%) had patella alta. 72 cases (91.1%) had equinus feet, and 49 cases (62.0%) had planovalgus feet deformities on radiographic studies. As the score of Gross motor function measure (GMFM) was decreased, the migration percentage (p<0.01), the Cobb's angle (p<0.01), the popliteal angle increased (p<0.001) and femur neck- shaft angle (p<0.05). CONCLUSION: Teenagers with cerebral palsy are highly risk to develop musculoskeletal deformities in their spine and the lower extremities. Therefore, a close medical inspection should be paid on this group.