PP06.7 – 2634: Musculoskeletal Deformities in a cross-sectional study of 204 consecutive paediatric patients with cerebral palsy (CP)

Objective The purpose of this study was to document the types and relative frequency of secondary musculoskeletal deformities in children with CP. Methods A cross-sectional study of 204 consecutive CP patients was performed in our hospital, during an 8-month period. Patients were examined by paediatric neurologists and orthopaedic surgeons and their medical records reviewed and updated. Results In total, 35/204 (17%) patients were GMFCS level I, 54/204 (26%) II, 31/204 (15%) III, 58/204 (28%) IV and 26/204 (12.7%) V. A subpopulation of 109/204 (53%) patients were identified with a documented diagnosis of secondary musculoskeletal problems. These problems included foot deformities, hip instability and neuromuscular scoliosis. Fixed foot deformities were documented in 50/204 (24.5%) patients: in 5/26 (19%) patients GMFCS V and in 21/58 (36%) patients GMFCS IV at an average age of 12 years (minimum 8 yrs), and in 24/120 (20%) patients in GMFCS groups I-III. The most common deformities were pes planovalgus (52%) and equinovarus (22%). Hip subluxation (Migration Percentage, MP ≥40%) or dislocation (MP 100%) was documented in 40/204 (19.6%) patients. In total, hip instability was diagnosed in 12/26 (46%), patients GMFCS V, at an average age of 5.5 years (minimum 3.5 yrs) and in 21/58 (36%) patients GMFCS IV, at an average age of 7.2 years (minimum 2.5 yrs). Hip instability was documented in 4/31 (13%) patients GMFCS III and in 3/54 (5.5%) patients GMFCS II. Neuromuscular scoliosis was documented in 6/204 (3%) patients at an average age of 14.5 years (minimum 10 yrs). Conclusions Musculoskeletal problems are common in children with CP. Hip instability can be detected and should be treated at an earlier age than foot or spine deformities. Treating physicians should have a high index of suspicion, in order to achieve early diagnosis, initiate treatment and prevent major problems in adolescence and adult life.