Cerebral palsy (CP) is a group of disorders that affect movement and posture caused by injury to the developing brain. Although prematurity and low birth weight are common causes in developed countries, birth asphyxia, kernicterus, and infections have been identified as predominant etiologies in Africa. There is, however, very little information on the etiology of CP in South Africa. We aimed to determine the etiology, severity, and topographic distribution of CP in children undergoing orthopedic surgery at our tertiary pediatric unit. A retrospective folder review was performed for patients with CP who underwent orthopedic surgery from July 2018 to June 2022. Data were collected on perinatal circumstances, etiologic risk factors for developing CP, severity of disability as classified by the Gross Motor Function Classification Scale (GMFCS), and topographic distribution. Descriptive analysis was performed. A total of 202 patients were included in the analysis. Prematurity (gestational age less than 37 weeks) was noted in 41.6% of the cohort and was the most common risk factor. Hypoxic-ischemic encephalopathy (30.7%), postnatal infections (13.4%), congenital brain malformations (10.4%), and cerebral infections were the next most common etiologic risk factors. Forty-eight percent of patients were classified as GMFCS IV or V. There was a predominance of bilateral (69.5%) compared with unilateral (21.3%) subtypes. Most patients undergoing orthopedic surgery for musculoskeletal sequelae of CP had GMFCS levels of IV or V and were bilateral subtypes, emphasizing the need for intervention at a primary care level to decrease the incidence of this frequently preventable condition.

中文翻译：

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南非骨科诊所的脑瘫病因危险因素

脑瘫 (CP) 是一组因发育中的大脑受伤而影响运动和姿势的疾病。尽管早产和低出生体重是发达国家的常见原因，但出生窒息、核黄疸和感染已被确定为非洲的主要病因。然而，关于南非脑瘫病因的信息非常少。我们的目的是确定在我们的三级儿科病房接受骨科手术的儿童 CP 的病因、严重程度和地形分布。对 2018 年 7 月至 2022 年 6 月接受骨科手术的 CP 患者进行了回顾性文件夹审查。收集了围产期情况、发生 CP 的病因危险因素、根据粗大运动功能分类量表 (GMFCS) 分类的残疾严重程度的数据。和地形分布。进行了描述性分析。总共 202 名患者被纳入分析。41.6% 的队列中出现早产（胎龄小于 37 周），这是最常见的危险因素。缺氧缺血性脑病（30.7%）、产后感染（13.4%）、先天性脑畸形（10.4%）和脑感染是其次最常见的病因危险因素。48% 的患者被分类为 GMFCS IV 或 V。与单侧 (21.3%) 亚型相比，双侧 (69.5%) 亚型占主导地位。大多数因 CP 肌肉骨骼后遗症而接受骨科手术的患者的 GMFCS 水平为 IV 或 V，并且属于双侧亚型，这强调需要在初级保健层面进行干预，以降低这种经常可预防的疾病的发生率。