Aversano Michael W, Sheikh Taha Abdel M, Mundluru Surya, Otsuka Norman Y
*NYU Langone Medical Center Hospital for Joint Diseases, New York †The Children's Hospital at Montefiore, The Pediatric Hospital of Albert Einstein College of Medicine, Bronx, NY.
J Pediatr Orthop. 2017 Apr/May;37(3):210-216. doi: 10.1097/BPO.0000000000000675.
The orthopaedic treatment of the patient with cerebral palsy (CP) is complex and must take into account the heterogeneity and natural history of the condition. Although the goals of management are for the most part universal, the specific interventions and outcome measures used to reach these goals are wide ranging. This update serves to summarize some of the recent publications in the field of pediatric orthopaedics that have made important contributions to our understanding and care of the patient with CP.
We searched the PubMed database using the following terms: "cerebral palsy" AND "orthopedic." The results were then filtered to include only review papers or clinical trials published in English from 2010 to 2014. The obtained list of references was then reviewed for publications in the fields of lower extremity muscle imbalance, foot and ankle deformities, hip and acetabular dysplasia, and advances in orthopaedic-related technology.
Updates in the field of pediatric orthopaedics are constant and the current level of evidence for the effectiveness of specific treatment modalities in patients with CP was reviewed. The search method yielded 153 publications, of which 31 papers were identified as having contributed important new findings.
Our understanding of orthopaedic treatments for children with CP continues to grow and expand. The studies reviewed illustrate just some of the strides we have taken in utilizing evidence-based surgical decision making in practice. Nevertheless, there remains a paucity of randomized controlled trials and higher evidence research, which may contribute to the variability in current practices among providers. By elucidating these gaps we can more purposefully delegate our time and resources into targeted areas of research.
Level 4-literature review.
脑瘫（CP）患者的骨科治疗复杂，必须考虑到该疾病的异质性和自然病史。尽管治疗目标在很大程度上是通用的，但用于实现这些目标的具体干预措施和结果指标却多种多样。本次更新旨在总结小儿骨科领域的一些近期出版物，这些出版物对我们理解和治疗CP患者做出了重要贡献。
我们使用以下术语在PubMed数据库中进行搜索：“脑瘫”和“骨科”。然后对结果进行筛选，仅纳入2010年至2014年以英文发表的综述论文或临床试验。然后对获得的参考文献列表进行审查，以查找有关下肢肌肉失衡、足踝畸形、髋部和髋臼发育不良以及骨科相关技术进展等领域的出版物。
小儿骨科领域的更新不断，并且对CP患者特定治疗方式有效性的当前证据水平进行了审查。搜索方法产生了153篇出版物，其中31篇论文被确定为有重要的新发现。
我们对CP患儿骨科治疗的理解不断发展和扩展。所审查的研究仅说明了我们在实践中利用循证外科决策所取得的一些进展。然而，随机对照试验和更高证据水平的研究仍然匮乏，这可能导致当前医疗服务提供者之间实践的差异。通过阐明这些差距，我们可以更有针对性地将时间和资源投入到有针对性的研究领域。
4级——文献综述。
