title: Skeletal maturation in children with quadriplegic cerebral palsy.
abstract: Skeletal growth abnormalities, including diminished linear growth and osteoporosis, are well recognized in children with severe cerebral palsy (CP). The purpose of this study was to examine skeletal bone age, another aspect of skeletal growth, in this severely handicapped population. The study consisted of two parts, each assessing skeletal maturation but using different methods on different cohorts of children with CP: 133 hand-wrist radiographs were scored using the Fels method and 241 pelvis radiographs were scored using the Oxford method. The Oxford method has not been validated against contemporary normal children; therefore, 114 recently obtained pelvis radiographs of otherwise normal children being evaluated for trauma were included as controls. On average, there was not a statistically significant difference between the chronological age of the child with CP and the skeletal age based on hand-wrist x-rays. Similarly, average pelvic skeletal maturity scores did not differ between the CP children and age-matched contemporary controls. While averages did not differ, wide individual variation was noted in the CP cohorts, with a high prevalence of both delayed and advanced skeletal maturity. Of note, pelvic maturity scores in the contemporary controls significantly differed from those reported in the original Oxford series from over 50 years ago.
authors.affiliation: University of North Carolina, Chapel Hill, North Carolina 27599, USA.
authors.forename: Shawn R
authors.initials: SR
authors.lastname: Gilbert
authors.forename: Adam C
authors.initials: AC
authors.lastname: Gilbert
authors.forename: Richard C
authors.initials: RC
authors.lastname: Henderson
mesh_terms: D000293:Adolescent; D000365:Age Determination by Skeleton / Q000379:methods*; D001846:Bone Development / Q000502:physiology*; D002547:Cerebral Palsy / Q000150:complications / Q000503:physiopathology*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D011782:Quadriplegia / Q000209:etiology / Q000503:physiopathology*