Bone Abstracts

Background: Cerebral Palsy (CP) is the most common physically disabling childhood motor disorder. Fractures in this group of children are common, however, prevalence and risk factors associated with fractures in children with CP in the UK is not known.

Aims: The aims of this cross-sectional survey were 1) to determine the prevalence of fractures in children with moderate-to-severe CP in Greater Manchester 2) to determine the common sites of fracture and 3) to identify risk factors associated with fractures.

Methods: This was a retrospective survey of a cohort of 96 children with CP and Gross Motor Functional Classification Score (GMFCS) levels III-V. Data were collected from Greater Manchester database of children with CP, clinical health records, radiograph imaging and central database of fragility fractures in children with developmental delay. Sex, age, seizures, seizure medications, nutritional status, presence of contractures, hip dislocations and fracture history were all collected and statistically analysed.

Results: Twelve children were found to have fractures, with a total of 23 fracture episodes, providing a prevalence of 12.5%. The median age of fractures was 6 years. Sixty six per cent of the fractures were found to occur in children with a GMFCS level of V, with a 66% of fractures occurring in a child who was fed via a gastrostomy (x²=7.14, df=1, P<0.008). The most common fracture site was around knee joint. Thirty per cent (GMFCS-5, n=3; GMFCS-3, n=1) of the children had multiple fractures.

Conclusion: The prevalence of fractures in children with CP was found to be consistent with the figures in literature. Of the risk factors studied, the use of a gastrostomy-feeding device was the only variable found to be associated with an increased fracture risk. However, the presence of a gastrostomy may be a marker of the severity of the child’s CP, predisposing them to fractures. Healthcare professionals and carers should be aware of the increased risk of non-traumatic fragility fractures in children with CP.

Disclosure: The authors declared no competing interests.