Changes in skeletal maturation and mineralization in children with cerebral palsy and evaluation of related factors

Abstract

Sixty-nine (28 females, 41 males) children with spastic cerebral palsy and 26 (13 females, 13 males) healthy children were included in the study. Total- and partial-body bone mineral content and bone mineral density values of patient and control subjects were measured by dual-energy x-ray absorptiometry. Left hand and wrist radiographs of all patients and right hand and wrist radiographs of 39 randomly selected patients were taken, and the bone ages of all radiographs were determined. In both female and male tetraplegics, bone mineralization values of lower extremities, where the mobility disorder and effects of absence of weight-bearing activity were maximal, were lower than those of controls and hemiplegics (P < .05). In 47 (68%) patients, left-side bone age values were below normal ranges for their ages, and the difference was statistically significant (P < .01). Our results indicate that motor function handicap affects skeletal mineralization adversely, and skeletal maturation is frequently delayed in children with cerebral palsy. We speculated that this delay might be a result of disrupted embryologic skeletal development due to hypoxic attack, which also causes the disease.