Kaspiris Angelos, Chronopoulos Efstathios, Vasiliadis Elias
Department of Trauma and Orthopaedics, Thriasio General Hospital-NHS, G. Gennimata av, Magoula 19600, Athens, Greece.
Second Department of Orthopaedic Surgery, Konstantopoulio General Hospital and Medical School, University of Athens, Athens 14233, Greece.
Children (Basel). 2016 Nov 18;3(4):34. doi: 10.3390/children3040034.
The most prevalent musculoskeletal disorder of childhood with unclear aetiology is growing pains (GPs). Anatomic deformities and factors that change bone turnover are implicated in GP pathophysiology. Perinatal risk factors alter the bone metabolism affecting the bone mineral density and content. The aim of our study was to analyze the relationship between GPs, knock knees and perinatal factors. The examined population consisted of 276 children aged 3-7 years. Among them, ten pairs of dizygotic twins were evaluated. The data were collected by using a combination of semi-structured questionnaires, clinical examinations and medical charts of the children and the obstetric history of the mothers. A total of 78 children presenting GPs met Peterson's criteria. Genu valgum severity was a significant factor for GP manifestation and for their increased frequency and intensity. Subsequently, perinatal factors regarding gestational age, Apgar score, head circumference (lower than 33 cm) and birth length or weight (smaller than 50 cm and 3000 g, respectively) made a remarkable contribution to the development of GPs. Conversely, antenatal corticosteroid treatment, increased maternal age and maternal smoking during pregnancy were not predictive of the disorder. Our data are potentially supportive for the "bone strength" theory and for the contribution of anatomical disturbances in GP appearance.
病因不明的儿童期最常见的肌肉骨骼疾病是生长痛(GPs)。解剖畸形和改变骨转换的因素与生长痛的病理生理学有关。围产期危险因素会改变骨代谢,影响骨矿物质密度和含量。我们研究的目的是分析生长痛、膝外翻和围产期因素之间的关系。研究对象为276名3至7岁的儿童。其中,对10对异卵双胞胎进行了评估。通过使用半结构化问卷、临床检查以及儿童的病历和母亲的产科病史相结合的方式收集数据。共有78名出现生长痛的儿童符合彼得森标准。膝外翻严重程度是生长痛表现及其频率和强度增加的一个重要因素。随后,关于胎龄、阿氏评分、头围(低于33厘米)以及出生身长或体重(分别小于50厘米和3000克)的围产期因素对生长痛的发生有显著影响。相反,产前皮质类固醇治疗、产妇年龄增加和孕期母亲吸烟并不能预测该疾病。我们的数据可能支持“骨强度”理论以及解剖结构紊乱在生长痛出现中的作用。