Namık Kemal Tıp Dergisi (Jun 2022)
Evaluation of Femoral Anteversion and Femoral Neck-Shaft Angles in Cerebral Palsy and a Review of the Literature
Abstract
Aim:Cerebral palsy (CP) is a chronic, sensorimotor disease as a result of damage in the brain that has not completed its development. In this study, we evaluated femoral anteversion (FA) and femoral neck-shaft (FNS) angles in pediatric patients with CP and studied whether there was a difference between the healthy population and patient group according to involvement subtypes or Gross Motor Functional Classification System (GMFCS).Materials and Methods:Thirty patients (20 females, 10 males; mean age 10 years 8 months; range 4 to 14 years) diagnosed with spastic CP, who had undergone surgery, were evaluated retrospectively. Of thirty patients, eleven were quadriplegic, ten were diplegic and nine were hemiplegic. Fifty-one hips of 30 patients were investigated in the study. According to the GMFCS, there were nine patients at level II, eight at level III, six at level IV, and seven at level V. X-rays and computed tomograhy images of the patient and control group were evaluated by radiological files of the hospital. FA and FNS angles of all patients were measured and the obtained values were compared.Results:The FNS angle (p<0.05) and the FA angle (p<0.05) were significantly larger in the patient group than in the control group. The FNS angle (p<0.05) and the FA angle (p<0.05) were significantly larger in the quadriplegic group than in the diplegic and hemiplegic groups. The FNS angle (p<0.05) and FA angle (p<0.05) were significantly larger in GMFCS level IV/V patients than in GMFCS level II/III patients.Conclusion:FA and FNS angles are increased in CP compared to normal population due to the spasticity in some muscles acting on the hip and the resulting imbalance in muscle strength. In quadriplegics, angles are significantly higher compared to diplegics and hemiplegics, GMFCS level IV/V had higher angle values compared to GMFCS II/III.
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