{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T03:31:09Z","timestamp":1792812669629,"version":"4.5.0"},"reference-count":12,"publisher":"Springer Science and Business Media LLC","issue":"8","license":[{"start":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T00:00:00Z","timestamp":1770768000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/deed.de"},{"start":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T00:00:00Z","timestamp":1770768000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/deed.de"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Orthop\u00e4die"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Hintergrund<\/jats:title>\n                    <jats:p>Die infantile Zerebralparese (ICP) ist eine der h\u00e4ufigsten Ursachen f\u00fcr k\u00f6rperliche Beeintr\u00e4chtigungen im Kindesalter. W\u00e4hrend das Gross Motor Function Classification System (GMFCS) die motorischen F\u00e4higkeiten beschreibt, fehlte bisher eine einheitliche Klassifikation f\u00fcr muskuloskelettale Pathologien. Das vorgestellte 4\u2011stufige System \u2013\u00a0entwickelt auf Basis des Mercer-Rang-Modells\u00a0\u2013 dient der Beschreibung der Krankheitsprogression der unteren Extremit\u00e4ten und unterst\u00fctzt Diagnose, Therapieplanung und Forschung.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Stadium\u00a01<\/jats:title>\n                    <jats:p>Muskul\u00e4re Hypertonie: Von der Geburt an bis zu einem Alter von 6\u00a0Jahren dominieren Spastizit\u00e4t und verz\u00f6gerte Motorikentwicklung; Kontrakturen sind selten. Fr\u00fchintervention und Spastiktherapie (z.\u202fB. Botulinumtoxin) stehen im Vordergrund.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Stadium\u00a02<\/jats:title>\n                    <jats:p>Kontrakturen: Zwischen\u00a04 und 12\u00a0Jahren f\u00fchren L\u00e4ngenunterschiede zwischen Muskeln und Knochen zu Bewegungseinschr\u00e4nkungen. Operative Muskel- oder Sehnenverl\u00e4ngerungen k\u00f6nnen notwendig werden.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Stadium\u00a03<\/jats:title>\n                    <jats:p>Kn\u00f6cherne Deformit\u00e4ten: Gleichzeitig entstehen kn\u00f6cherne Fehlstellungen wie femorale Antetorsion oder Pes valgus mit Kontrakturen, kombinierte Multilevel-Eingriffe (SEMLS) sind oft indiziert.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Stadium\u00a04<\/jats:title>\n                    <jats:p>Dekompensierte Pathologien: Nach der Pubert\u00e4t treten irreversible Fehlstellungen und Gelenkdegenerationen auf. Eingriffe dienen meist der Schmerzreduktion oder Stabilisierung (z.\u202fB. Arthrodese).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Schlussfolgerung<\/jats:title>\n                    <jats:p>Das System f\u00f6rdert das Bewusstsein f\u00fcr die Krankheitsprogression, erleichtert die Wahl stadiengerechter Therapien und kann \u00dcber- oder Unterbehandlungen vermeiden. Fr\u00fchzeitige Interventionen sind entscheidend, um Dekompensationen vorzubeugen und die funktionellen Ergebnisse zu verbessern.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00132-026-04776-2","type":"journal-article","created":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T17:38:59Z","timestamp":1770831539000},"page":"641-647","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Muskuloskelettale Pathologien bei Kindern mit infantiler Zerebralparese: ein neues Klassifikationssystem","Musculoskeletal pathology in children with infantile cerebral palsy: a new classification system"],"prefix":"10.1007","volume":"55","author":[{"given":"L. M.","family":"Kessling","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. 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