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ORIGINAL RESEARCH

Fracture Rates in Children with Cerebral Palsy: A Danish, Nationwide Register-Based Study

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Pages 1405-1414 | Received 21 Jul 2022, Accepted 18 Oct 2022, Published online: 22 Nov 2022
 

Abstract

Background

In children with cerebral palsy (CP), fracture rates have been reported to be higher than in the general population but age-specific fracture rates have not been directly compared and the effect of comorbid epilepsy needs elucidation. This impairs decision-making regarding bone health interventions.

Aim

We aimed to establish the age-specific fracture rates in children with CP with and without epilepsy in Denmark.

Materials and Methods

Data from Danish registers were combined to establish cohorts of children with and without CP born in Denmark from 1997 to 2007. Fracture rates were calculated for 1997–2016.

Results

We identified 1,451 children with CP and 787,159 without CP. Female/male fracture rates per 1,000 person-years were 23/27 with CP and 23/29 without CP. Male sex, epilepsy and anti-seizure medication, but not the diagnosis of CP or GMFCS-level, were associated with higher fracture rates. Relatively more lower extremity fractures occurred in non-ambulant children with CP.

Interpretation/Conclusion

We found no increased fracture rates in children with CP when compared to peers; however, fracture locations suggested bone fragility in non-ambulant children. All children with epilepsy and on anti-seizure medication had increased fracture rates. We suggest bone health optimization in these groups.

Disclosure

Dr Bente Langdahl reports grants and/or personal fees from Amgen, UCB, Eli Lilly, Gedeon-Richter, Astra-Zenica, and Astella, outside the submitted work. The authors report no other conflicts of interest in this work.

Additional information

Funding

Denmark Central Region Health Research Fund; Elsass Foundation; Randers Regional Hospital, Denmark; Aarhus University, Denmark.