Progression of planovalgus deformity in patients with cerebral palsy
Abstract Background Analyzing radiographic changes of pes planovalgus(PV) deformity of cerebral palsy(CP) patients according to age and influencing factors. Methods CP patients with PV deformity younger than 18 years old who had undergone more than a year of follow-up with at least two standing foot...
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| Format: | Article |
| Language: | English |
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BMC
2020-03-01
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| Series: | BMC Musculoskeletal Disorders |
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| Online Access: | http://link.springer.com/article/10.1186/s12891-020-3149-0 |
| _version_ | 1819038022912442368 |
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| author | Jae Jung Min Soon-Sun Kwon Ki Hyuk Sung Kyoung Min Lee Chin Youb Chung Moon Seok Park |
| author_facet | Jae Jung Min Soon-Sun Kwon Ki Hyuk Sung Kyoung Min Lee Chin Youb Chung Moon Seok Park |
| author_sort | Jae Jung Min |
| collection | DOAJ |
| description | Abstract Background Analyzing radiographic changes of pes planovalgus(PV) deformity of cerebral palsy(CP) patients according to age and influencing factors. Methods CP patients with PV deformity younger than 18 years old who had undergone more than a year of follow-up with at least two standing foot radiographs were included. Anteroposterior and lateral talo-first metatarsal(talo-1stMT), talo-second metatarsal(talo-2ndMT), and hallux valgus(HV) angles were measured on the radiographs. The rate of progression was adjusted by multiple factors using the linear mixed model, with the Gross Motor Function Classification System(GMFCS) level as the fixed effect and age and each subject as random effects. Results Overall, 194 patients were enrolled in this study, and 1272 standing foot radiographs were evaluated. The AP talo-2ndMT angle progressed by 0.59° (p < 0.0001) and 0.64° (p = 0.0007) in GMFCS level II and III patients, respectively; however, there was no significant change in GMFCS level I patients (p = 0.3269). HV was significantly affected by age in all three GMFCS groups; it increased by 0.48° (p < 0.0001), 0.66° (p < 0.0001), and 1.19° (p < 0.0001) for levels I, II, and III, respectively. The lateral talo-1stMT angle showed improvements in GMFCS level I and II patients (0.43°, p < 0.0001, and 0.61°, p < 0.0001, respectively). In GMFCS level III patients, there was no significant improvement in the lateral talo-1stMT angle (p = 0.0535). Conclusions The GMFCS level was the single most important factor influencing the progression of radiographic indices in PV deformity in CP. The AP talo-1stMT and talo-2ndMT angles progressed in patients with GMFCS levels II and III. Physicians should take this result into consideration when planning the timing of the surgery. Level of evidence Prognostic Level IV. |
| first_indexed | 2024-12-21T08:30:42Z |
| format | Article |
| id | doaj.art-4b652bc323c34f29ba61ba0892a31372 |
| institution | Directory Open Access Journal |
| issn | 1471-2474 |
| language | English |
| last_indexed | 2024-12-21T08:30:42Z |
| publishDate | 2020-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Musculoskeletal Disorders |
| spelling | doaj.art-4b652bc323c34f29ba61ba0892a313722022-12-21T19:10:13ZengBMCBMC Musculoskeletal Disorders1471-24742020-03-012111810.1186/s12891-020-3149-0Progression of planovalgus deformity in patients with cerebral palsyJae Jung Min0Soon-Sun Kwon1Ki Hyuk Sung2Kyoung Min Lee3Chin Youb Chung4Moon Seok Park5Department of Orthopedic Surgery, Seoul National University Bundang HospitalDepartment of Mathematics, College of Natural Sciences, Ajou UniversityDepartment of Orthopedic Surgery, Seoul National University Bundang HospitalDepartment of Orthopedic Surgery, Seoul National University Bundang HospitalDepartment of Orthopedic Surgery, Seoul National University Bundang HospitalDepartment of Orthopedic Surgery, Seoul National University Bundang HospitalAbstract Background Analyzing radiographic changes of pes planovalgus(PV) deformity of cerebral palsy(CP) patients according to age and influencing factors. Methods CP patients with PV deformity younger than 18 years old who had undergone more than a year of follow-up with at least two standing foot radiographs were included. Anteroposterior and lateral talo-first metatarsal(talo-1stMT), talo-second metatarsal(talo-2ndMT), and hallux valgus(HV) angles were measured on the radiographs. The rate of progression was adjusted by multiple factors using the linear mixed model, with the Gross Motor Function Classification System(GMFCS) level as the fixed effect and age and each subject as random effects. Results Overall, 194 patients were enrolled in this study, and 1272 standing foot radiographs were evaluated. The AP talo-2ndMT angle progressed by 0.59° (p < 0.0001) and 0.64° (p = 0.0007) in GMFCS level II and III patients, respectively; however, there was no significant change in GMFCS level I patients (p = 0.3269). HV was significantly affected by age in all three GMFCS groups; it increased by 0.48° (p < 0.0001), 0.66° (p < 0.0001), and 1.19° (p < 0.0001) for levels I, II, and III, respectively. The lateral talo-1stMT angle showed improvements in GMFCS level I and II patients (0.43°, p < 0.0001, and 0.61°, p < 0.0001, respectively). In GMFCS level III patients, there was no significant improvement in the lateral talo-1stMT angle (p = 0.0535). Conclusions The GMFCS level was the single most important factor influencing the progression of radiographic indices in PV deformity in CP. The AP talo-1stMT and talo-2ndMT angles progressed in patients with GMFCS levels II and III. Physicians should take this result into consideration when planning the timing of the surgery. Level of evidence Prognostic Level IV.http://link.springer.com/article/10.1186/s12891-020-3149-0Pes planovalgusTalo-first metatarsal angleTalo-second metatarsal angleProgressionCerebral palsy |
| spellingShingle | Jae Jung Min Soon-Sun Kwon Ki Hyuk Sung Kyoung Min Lee Chin Youb Chung Moon Seok Park Progression of planovalgus deformity in patients with cerebral palsy BMC Musculoskeletal Disorders Pes planovalgus Talo-first metatarsal angle Talo-second metatarsal angle Progression Cerebral palsy |
| title | Progression of planovalgus deformity in patients with cerebral palsy |
| title_full | Progression of planovalgus deformity in patients with cerebral palsy |
| title_fullStr | Progression of planovalgus deformity in patients with cerebral palsy |
| title_full_unstemmed | Progression of planovalgus deformity in patients with cerebral palsy |
| title_short | Progression of planovalgus deformity in patients with cerebral palsy |
| title_sort | progression of planovalgus deformity in patients with cerebral palsy |
| topic | Pes planovalgus Talo-first metatarsal angle Talo-second metatarsal angle Progression Cerebral palsy |
| url | http://link.springer.com/article/10.1186/s12891-020-3149-0 |
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