Department of Women's and Children's Health, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
Department of Pediatric Orthopedics, Astrid Lindgren's Children Hospital, Karolinska University Hospital, Stockholm, Sweden.
BMC Musculoskelet Disord. 2024 Nov 19;25(1):930. doi: 10.1186/s12891-024-08029-1.
Foot deformities, such as valgus and varus in the coronal plane and equinus in the sagittal plane, are common in children with cerebral palsy (CP). The purpose of this study was to describe the prevalence of coronal plane foot deformities and their association with the Gross Motor Function Classification System (GMFCS) level, age, CP subtype, and equinus in children with CP.
A cross-sectional study was performed of 2784 children (1644 boys, 1140 girls), mean age 10 years, 2 months (standard deviation, 4.83), from the Swedish CP Follow-up Program and registry for 2021-2023. Single and multiple binary regression analyses estimated the association between coronal plane foot deformities (valgus or varus) and sex, age, GMFCS level, CP subtype, and equinus.
More than half (58%) the children with CP had valgus feet and 6% had varus feet. Valgus feet were more common in young children with high GMFCS levels, whereas the number of varus feet remained consistently low across all GMFCS levels. The prevalence of valgus feet was lower in older children at GMFCS I and II, but remained high in older children at GMFCS III-V. Coronal plane foot deformities were associated with higher GMFCS levels (odds ratio [OR] 11, 95% confidence interval [CI] 8-15 for GMFCS V), lower age (OR 1.5, 95% CI 1.3-1.7), and equinus (OR 1.9, 95% CI 1.4-2.5).
Most children with CP have a coronal plane foot deformity. Valgus is most commonly associated with higher GMFCS levels and lower age. These findings contribute to a mapping of the children with an increased risk of foot deformities and also highlight the need for continuous follow-up of foot deformities in children with CP.
足畸形，如冠状面的外翻和内翻以及矢状面的马蹄足，在脑瘫（CP）儿童中很常见。本研究旨在描述 CP 儿童冠状面足畸形的流行情况及其与粗大运动功能分类系统（GMFCS）水平、年龄、CP 亚型和马蹄足的关系。
对 2021 年至 2023 年参加瑞典 CP 随访计划和登记处的 2784 名儿童（男 1644 名，女 1140 名）进行了横断面研究，平均年龄为 10 岁 2 个月（标准差 4.83）。采用单因素和多因素二项回归分析评估了冠状面足畸形（外翻或内翻）与性别、年龄、GMFCS 水平、CP 亚型和马蹄足之间的关系。
超过一半（58%）的 CP 儿童有足外翻，6%有足内翻。足外翻在 GMFCS 水平较高的幼儿中更为常见，而足内翻的数量在所有 GMFCS 水平下均保持较低。GMFCS I 和 II 级的大龄儿童足外翻的患病率较低，但 GMFCS III-V 级的大龄儿童足外翻的患病率仍然较高。冠状面足畸形与 GMFCS 水平较高（GMFCS V 的优势比 [OR] 11，95%置信区间 [CI] 8-15）、年龄较小（OR 1.5，95% CI 1.3-1.7）和马蹄足（OR 1.9，95% CI 1.4-2.5）相关。
大多数 CP 儿童存在冠状面足畸形。外翻最常与 GMFCS 水平较高和年龄较小相关。这些发现有助于对足畸形风险增加的儿童进行映射，也凸显了 CP 儿童中足畸形连续随访的必要性。
