Article

Skeletal abnormalities, affecting posture and walking pattern, increase with
motor impairment in children with cerebral palsy (CP).
However, it is not known
whether these skeletal malalignments occur in children with slight motor
impairment. Our aim was to evaluate skeletal malalignment at the level of the
pelvis and lower limbs in ambulant children with CP, with slight motor
impairment, using a low dose biplanar X-ray technique.
Twenty-seven children with
spastic CP (mean age: 10.9+/-4years, 7 Hemiplegia, 20 Diplegia, GMFCS levels
I:17, II:10), with no previous treatments at the hips and knees, underwent
EOS((R)) biplanar X-rays. A control group consisting of 22 typically developing
children was also included. Three-dimensional reconstructions of the pelvis and
lower limbs were performed in order to calculate 11 radiological parameters
related to the pelvis, acetabulum and lower limbs. Pelvic incidence and sacral
slope were significantly increased in children with CP compared to TD children
(48 degrees +/-7 degrees vs. 43 degrees +/-8 degrees , 42 degrees +/-7 degrees
vs. 38 degrees +/-5 degrees , respectively, p=0.003). Acetabular parameters did
not significantly differ between the two groups. Femoral anteversion and neck
shaft angle were significantly increased in children with CP (25 degrees +/-12
degrees vs. 14 degrees +/-7 degrees , p<0.001; 134 degrees +/-5 degrees vs. 131
degrees +/-5 degrees , p=0.005 respectively). No difference was found for tibial
torsion. This study showed that even slightly impaired children with CP have an
anteverted and abducted femur and present positional and morphological changes of
the pelvis in the sagittal plane. The orientation of the acetabulum in 3D seems
to not be affected when children with CP present slight motor impairment.
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Langue : ANGLAIS