{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T12:25:51Z","timestamp":1789993551610,"version":"4.0.1"},"reference-count":25,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2018,3,8]],"date-time":"2018-03-08T00:00:00Z","timestamp":1520467200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Develop Med Child Neuro"],"published-print":{"date-parts":[[2018,6]]},"abstract":"<jats:sec><jats:title>Aim<\/jats:title><jats:p>The prevalence of severely symptomatic deformities of the first metatarsophalangeal (<jats:styled-content style=\"fixed-case\">MTP<\/jats:styled-content>) joint in adolescents with cerebral palsy (<jats:styled-content style=\"fixed-case\">CP<\/jats:styled-content>) requiring arthrodesis is unknown. Recent literature regarding these deformities is limited. We studied the presentation of severe, symptomatic deformities of the first ray in a large population of children and adolescents with <jats:styled-content style=\"fixed-case\">CP<\/jats:styled-content> and their association with gross motor function, <jats:styled-content style=\"fixed-case\">CP<\/jats:styled-content> subtype, and other musculoskeletal deformities.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>We identified 41 patients with <jats:styled-content style=\"fixed-case\">CP<\/jats:styled-content> and a symptomatic deformity of the first <jats:styled-content style=\"fixed-case\">MTP<\/jats:styled-content> joint, managed by arthrodesis, from a large population based database over a 21\u2010year period. Information recorded included demographics, <jats:styled-content style=\"fixed-case\">CP<\/jats:styled-content> subtype, Gross Motor Function Classification System (<jats:styled-content style=\"fixed-case\">GMFCS<\/jats:styled-content>), clinical presentation, and radiological features.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Adolescents with spastic diplegia, at <jats:styled-content style=\"fixed-case\">GMFCS<\/jats:styled-content> levels <jats:styled-content style=\"fixed-case\">II<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">III<\/jats:styled-content>, were the most common group to develop symptomatic hallux valgus. In contrast, non\u2010ambulant adolescents, at <jats:styled-content style=\"fixed-case\">GMFCS<\/jats:styled-content> levels <jats:styled-content style=\"fixed-case\">IV<\/jats:styled-content> and V, with dystonia or mixed tone, more commonly had dorsal bunions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Interpretation<\/jats:title><jats:p>The type of first <jats:styled-content style=\"fixed-case\">MTP<\/jats:styled-content> joint deformity in patients with <jats:styled-content style=\"fixed-case\">CP<\/jats:styled-content> may be predicted by the type and distribution of movement disorder, and by <jats:styled-content style=\"fixed-case\">GMFCS<\/jats:styled-content> level. Specific patterns of associated musculoskeletal deformities may contribute to the development of these disorders and may provide a guide to surgical management.<\/jats:p><\/jats:sec><jats:sec><jats:title>What this paper adds<\/jats:title><jats:p>\n<jats:list list-type=\"bullet\">\n\n<jats:list-item><jats:p>The prevalence of severe bunions requiring fusion surgery was 2%.<\/jats:p><\/jats:list-item>\n\n<jats:list-item><jats:p>The two types of bunion were hallux valgus and dorsal bunion.<\/jats:p><\/jats:list-item>\n\n<jats:list-item><jats:p>The type of bunion can be identified on both clinical and radiological grounds.<\/jats:p><\/jats:list-item>\n\n<jats:list-item><jats:p>The cerebral palsy subtype is predictive of the type of bunion.<\/jats:p><\/jats:list-item>\n<\/jats:list>\n<\/jats:p><\/jats:sec>","DOI":"10.1111\/dmcn.13724","type":"journal-article","created":{"date-parts":[[2018,3,8]],"date-time":"2018-03-08T12:26:47Z","timestamp":1520512007000},"page":"624-628","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Symptomatic hallux valgus and dorsal bunion in adolescents with cerebral palsy: clinical and biomechanical factors"],"prefix":"10.1111","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3305-959X","authenticated-orcid":false,"given":"Samuel K","family":"van de Velde","sequence":"first","affiliation":[{"name":"Orthopaedic Department The Royal Children's Hospital Parkville Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megan","family":"Cashin","sequence":"additional","affiliation":[{"name":"Orthopaedic Department The Royal Children's Hospital Parkville Victoria 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