Fracture Risk and Cerebral Palsy

Recently a retrospective study was completed of 536 children with cerebral palsy to examine the risk of fractures in this population.  The results indicated the following:

• the risk of fracture for all of the children in this study was the same as the general population
• for children with GMFCS levels I-III there was no association between fractures and the risk factors studied (ie sex, gastrostomy, height, weight, type of CP, use of standing frame or antiepileptic drugs)
• there was a two fold increase in risk of fractures for children GMFCS levels IV-V on antiepileptic drugs
• fracture risk was increased in children with stunted growth who were more than 3 standard deviations below the norm for height
• fracture risk had a four fold reduction in risk for children who used standing frames

The researchers concluded that regular loading through the use of standing frames and adequate nutritional intake to prevent stunted growth may help to reduce the risk of fractures in children with cerebral palsy.

Always nice to have more research to add to letters of justification for the use of standing frames for children with cerebral palsy.

Reference: Uddenfeldt Wort U, Nordmark E, Wagner P, Düppe H, Westbom L. Fractures in children with cerebral palsy: a total population study. Dev Med Child Neurol. 2013 Jun 11. doi: 10.1111/dmcn.12178. [Epub ahead of print]