BONE MINERALIZATION IN THE AFFECTED EXTREMITIES OF CHILDREN WITH SPASTIC HEMIPLEGIA

To assess the impact of neurologic involvement on bone mineralization, dual-energy X-ray absorptiometry was used to quantitate bone mineral cont-nt (BMC), bone mineral density (BMD), fat and lean muscle mass in the limbs: of 19 children with spastic hemiplegic cerebral palsy. The BMC in the affected limb was on average 26.5% lower (upper limbs) and 15.6% lower (lower limbs) than in the corresponding uninvolved limb. Lean muscle mass was reduced by 15% and BMD by 6% in the involved limb s and did not differ significantly between upper and lower limbs. The fat content of involved and uninvolved limbs did not differ. Children with poor hand function had greater reductions in BMC (39.3%), BMD (11 .3%) and lean muscle mass (22.5%) than did children with better hand f unction. Thus, bone size and density decrease with increasing neurolog ic involvement, and weight bearing may slightly lessen the effect.