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Fracture characteristics by age, sex, and ambulatory status among individuals with cerebral palsy: a descriptive study.
Kannikeswaran, Sanjana; French, Zachary P; Walsh, Kevin; Swallow, Jennylee; Caird, Michelle S; Whitney, Daniel G.
Afiliación
  • Kannikeswaran S; Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI, USA.
  • French ZP; Department of Orthopedics and Rehabilitation, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
  • Walsh K; Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, MI, USA.
  • Swallow J; Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, MI, USA.
  • Caird MS; Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, MI, USA.
  • Whitney DG; Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI, USA.
Disabil Rehabil ; 44(17): 4806-4812, 2022 08.
Article en En | MEDLINE | ID: mdl-33962527
PURPOSE: To evaluate clinically relevant fracture characteristics by age, sex, and ambulatory status among individuals with cerebral palsy. METHODS: Fracture location, energy of fracture, and activities that lead to a fracture were assessed among a clinic-based sample of children (0-17 years; n = 57) and adults (18-70 years; n = 58) with cerebral palsy that sustained a fracture by sex and gross motor function classification system (GMFCS) I-III vs. IV/V. RESULTS: Proportion of fractures that were low-energy was 67-99% for children and 69-84% for adults. ∼2/3rds of fractures were at the lower extremities, with the distal femur being the most common site for children (44%) and the foot/ankle for adults (40%); however, there were age, sex, and ambulatory effects, such that 43% of adults GMFCS IV/V and 32% of women had a distal femur fracture. GMFCS I-III were more likely to fracture from functionally complex activities, while GMFCS IV/V were more likely to fracture from wheelchair/transfers/limb-stuck and incidental findings. CONCLUSIONS: The majority of fractures were low-energy and occurred in the lower extremities, with effects by age, sex, and GMFCS. Activities that led to a fracture also differed by age and GMFCS, which can be used to design fracture prevention interventions in addition to bolstering skeletal mass and architecture.Implications for rehabilitationSkeletal fragility is a major problem for individuals with cerebral palsy (CP) across the lifespan leading to an increased risk of fragility fractures.Rehabilitation is a prime clinical intervention to prevent fractures from occurring and improving post-fracture healing and function; yet, effective rehabilitation interventions require knowledge of fracture characteristics, such as where fractures are occurring and the activities that lead to the fracture event specific to individuals with CP.Using a clinic-based sample of 0-70 year olds with CP, we describe salient fracture characteristics based on age, sex, and ambulatory status to enhance translation into clinical and rehabilitation practice.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Parálisis Cerebral / Fracturas Óseas Tipo de estudio: Etiology_studies Límite: Adult / Child / Female / Humans Idioma: En Revista: Disabil Rehabil Asunto de la revista: REABILITACAO Año: 2022 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Parálisis Cerebral / Fracturas Óseas Tipo de estudio: Etiology_studies Límite: Adult / Child / Female / Humans Idioma: En Revista: Disabil Rehabil Asunto de la revista: REABILITACAO Año: 2022 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido