Bone Abstracts

Limb length discrepancy has been observed in children with hemiplegic cerebral palsy (HCP). However, the difference of bone age and limb lengths have been a controversial issue. The purpose of this study was to analyze the bone age and the upper extremity segmental lengths between affected and naffected in HCP patients.

Seventy-eight patients (39 boys and 39 girls; mean age 71.3±28.1 months). Fourty-five children were right and 33 were left hemiplegia. The bone ages of affected and unaffected hand-wrists were determined by the Greulich and Pyle atlas. Each of the upper extremity segmental lengths composed of humerus, ulna, radius, and 3rd metacarpal bones were measured by radiograph. Hand function was classified by manual ability classification system (MACS).

The mean bone age was 66.7±33.5 months in the affected side and 68.9±33.7 months in the unaffected side (P<0.001). Fifty-one of the patients performed X-rays of the upper extremities and all segmental lengths of the upper extremities, and showed significant differences between affected and unaffected side in the upper extremities (P<0.001). However, the difference of side-to-side bone age revealed no statistical significant correlation with segmental upper limb length discrepancies. Hand function of fifty-six patients was evaluated by MACS and the MACS level of the affected hand showed correlation with difference of side-to-side bone age (r=0.29, P=0.03) and all segmental upper limb length discrepancies (P<0.05). The hand function of affected side was delayed compared to unaffected side in the bone-age-delayed group (P<0.01).

The bone age of the affected side compared to the unaffected side is delayed in the HCP and the hand function of the affected side is correlated with the difference of side-to-side bone age and the upper limb length discrepancy in the HCP. Through this study, hand function might be helpful for predicting potential limb shortness and delayed bone age in HCP.