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Fractures in Children and Adolescents with Spina Bifida: The Experience of a Portuguese Tertiary-Care Hospital

2010-08Journal article Open access
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dc.contributor.authorMarreiros, H
dc.contributor.authorMonteiro, L
dc.contributor.authorLoff, C
dc.contributor.authorCalado, E
dc.date.accessioned2016-05-11T12:11:21Z
dc.date.available2016-05-11T12:11:21Z
dc.date.issued2010-08
dc.description.abstractAIM: The morbidity associated with osteoporosis and fractures in children and adolescents with spina bifida highlights the importance of osteoporosis prevention and treatment in these patients. The aim of this study was to examine the occurrence and pattern of bone fractures in paediatric patients with spina bifida. METHOD: We reviewed the data of all paediatric patients with spina bifida who were treated in our centre between 1999 and 2008. RESULTS: One hundred and thirteen patients were included in the study (63 females, 50 males; mean age 10y 8mo, SD 4y 10mo, range 6mo-18y). The motor levels were thoracic in six, upper lumbar in 22, lower lumbar in 42, and sacral in 43 patients. Of the 113 patients, 58 (51.3%) had shunted hydrocephalus. Thirty-six (31.8%) were non-ambulatory (wheelchair-dependent [unable to self-propel wheelchair] n=3, wheelchair-independent [able to self-propel wheelchair] n=33), 13 were partial ambulators, 61 were full ambulators, and three were below the age of walking. Forty-five fractures were reported in 25 patients. The distal femur was the most common fracture site. Statistical analyses showed that patients with higher levels of involvement and in wheelchairs had a significantly increased risk of having a [corrected] fracture (p<0.001). Spontaneous fractures were the principal mechanism of injury, and an association was identified between fracture mechanism, type of ambulation, and lesion level: the fractures of patients with higher levels of motor functioning and those in wheelchairs were mainly pathological (p=0.01). We identified an association between risk of a second fracture, higher motor level lesion, and non-ambulation. There was an increased risk of having a second fracture after a previous spontaneous fracture (p=0.004). INTERPRETATION: Data in this study indicate a high prevalence of fractures in patients with spina bifida.pt_PT
dc.identifier.citationDev Med Child Neurol. 2010 Aug;52(8):754-9pt_PT
dc.identifier.doi10.1111/j.1469-8749.2010.03658.xpt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/2484
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherMac Keith Presspt_PT
dc.subjectFractures, Bone/diagnosispt_PT
dc.subjectFractures, Bone/epidemiologypt_PT
dc.subjectHospitals/statistics & numerical datapt_PT
dc.subjectSeverity of Illness Indexpt_PT
dc.subjectSpinal Dysraphism/epidemiologypt_PT
dc.subjectPrevalencept_PT
dc.subjectPortugal/epidemiologypt_PT
dc.subjectAdolescentpt_PT
dc.subjectChildpt_PT
dc.subjectHDE NEU PEDpt_PT
dc.subjectHDE MFRpt_PT
dc.titleFractures in Children and Adolescents with Spina Bifida: The Experience of a Portuguese Tertiary-Care Hospitalpt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage759pt_PT
oaire.citation.issue8pt_PT
oaire.citation.startPage754pt_PT
oaire.citation.volume52pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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